Transmission of multidrug-resistant Gram-negative bacteria from colonized mothers to their infants: a systematic review and meta-analysis.
J Hosp Infect. 2019 Oct 08;:
Authors: Bulabula ANH, Dramowski A, Mehtar S
AIM: To review the molecular evidence supporting transmission of multidrug-resistant Gram-negative bacteria (MDR-GNB) from colonized mothers to their infants and the risk factors for MDR-GNB transmission.
METHODS: We searched PubMed and Scopus for studies investigating the mechanisms, risk factors for and/or scale of transmission of MDR-GNB from colonized mothers to their infants. We performed random effects meta-analyses to determine pooled proportions of MDR-GNB transmission and the neonatal outcomes of transmission.
FINDINGS: Eight studies were included in the narrative description and seven in the meta-analysis. Five studies used pulsed-field gel electrophoresis (PFGE) to assess relatedness of isolates from colonized mothers and their infants. Pooled proportion of MDR-GNB transmission from colonized mothers to their infants was 27% (95% confidence interval, 8 - 47%). ESBL-producing Enterobacteriaceae, were the most frequently studied MDR-GNB pathogens transmitted between mother-infant pairs. Following mother to infant transmission of an MDR-GNB pathogen, the pooled proportion for the outcome of neonatal colonization was 19% (95% CI 3 - 35%).
CONCLUSIONS: This systematic review strongly supports MDR- and/or ESBL Enterobacteriaceae transmission from colonized mothers to their infants, with subsequent infant colonization. The risk factors contributing to transmission of MDR-GNB between colonized mothers and their infants warrants further research.
PMID: 31604126 [PubMed - as supplied by publisher]