Nasal and vaginal colonization of methicillin-resistant Staphylococcus aureus in pregnant women in Cartagena, Colombia
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Objectives: To determine the prevalence of nasal and vaginal colonization of SA and the antibiotic susceptibility of the isolates in pregnant women attending a maternity hospital in Cartagena, Colombia.
Methods: Nasal and vaginal swabs were obtained from participants and subjected to microbiological and molecular assays. A post discharge follow-up was performed for up to four weeks.
Results: From 100 pregnant women enrolled in the study, 34 were colonized with SA; 29 only in the nares, three only in the vagina, and two at both sites. Colonization of pregnant women with SA was more common in the nares than in the vagina or at both sites [29/34 (85.3%) vs 3/34 (8.8%) and 2/34 (5.9%); p<0.05]. We obtained 36 SA isolates, nine (25%) of which were methicillin-resistant Staphylococcus aureus (MRSA), one was from the vagina; thus, the overall MRSA colonization rate among pregnant women was 9%. Molecular analysis showed that Panton-Valentine leukocidin (PVL) genes were carried by the vaginal MRSA, seven of the nasal MRSA, and two of the Methicillinsensitive Staphylococcus aureus (MSSA) isolates. Two MRSA isolates carried SCCmec type I and seven carried SCCmec type IV.
Conclusions: Nasal colonization rate for SA in the study population was similar to previous reports. However, the frequency of nasal colonization of MRSA was higher while vaginal colonization of SA was lower than previously
reported in other studies for similar populations. The MRSA isolates obtained showed a community profile.
- Staphylococcus aureus
- Methicillin-resistance
- Maternal colonization
- Virulence factor
- Pregnancy
Peacock SJ, de Silva I, Lowy FD. What deter-mines nasal carriage of Staphylococcus aureus? Trends Microbiol 2001;9:605-10. DOI: https://doi.org/10.1016/S0966-842X(01)02254-5
Safdar N, Bradley EA. The risk of infection after nasal colonization with Staphylococcus aureus. Am J Med 2008;121:310-5. DOI: https://doi.org/10.1016/j.amjmed.2007.07.034
Zetola N, Francis JS, Nuermberger EL, Bishai WR. Communityacquired methicillin-resistant Staphylococcus aureus: an emerging threat. . Lancet Infect Dis 2005;5:275–86. DOI: https://doi.org/10.1016/S1473-3099(05)70112-2
Huang YC, Chao AS, Chang SD, et al. Asso-ciation of Staphylococcus aureus colonization in parturient mothers and their babies. Pediatr Infect Dis J 2009;28:742-4. DOI: https://doi.org/10.1097/INF.0b013e31819c132a
Reusch M, Ghosh P, Ham C, Klotchko A, Singapuri S, Everett G. Prevalence of MRSA colonization in peripartum mothers and their newborn infants. Scand J Infect Dis 2008;40:667-71. DOI: https://doi.org/10.1080/00365540801946520
Laibl VR, Sheffield JS, Roberts S, McIntire DD, Trevino S, Wendel GD, Jr. Clinical presen-tation of community-acquired methicillin-re-sistant Staphylococcus aureus in pregnancy. Obstet Gynecol 2005;106:461-5. DOI: https://doi.org/10.1097/01.AOG.0000175142.79347.12
Chen KT, Campbell H, Borrell LN, Huard RC, Saiman L, Della-Latta P. Predictors and outcomes for pregnant women with vaginal-rectal carriage of community-associated me-thicillin-resistant Staphylococcus aureus. Am J Perinatol 2007;24:235-40. DOI: https://doi.org/10.1055/s-2007-976551
Stumpf PG, Flores M, Murillo J. Serious pos-tpartum infection due to MRSA in an asymp-tomatic carrier: case report and review. Am J Perinatol 2008;25:413-5. DOI: https://doi.org/10.1055/s-2008-1075032
Beigi R, Hanrahan J. Staphylococcus aureus and MRSA colonization rates among gravidas admitted to labor and delivery: a pilot study. Infect Dis Obstet Gynecol 2007;2007:70876. DOI: https://doi.org/10.1155/2007/70876
Chen KT, Huard RC, Della-Latta P, Saiman L. Prevalence of methicillin-sensitive and methi-cillin-resistant Staphylococcus aureus in preg-nant women. Obstet Gynecol 2006;108:482-7. DOI: https://doi.org/10.1097/01.AOG.0000227964.22439.e3
Andrews WW, Schelonka R, Waites K, Stamm A, Cliver SP, Moser S. Genital tract me-thicillin-resistant Staphylococcus aureus: risk of vertical transmission in pregnant women. Obstet Gynecol 2008;111:113-8. DOI: https://doi.org/10.1097/01.AOG.0000298344.04916.11
Bourgeois-Nicolaos N, Lucet JC, Dau-bie C, et al. Maternal vaginal colonisation by Staphylococcus aureus and newborn acqui-sition at delivery. Paediatr Perinat Epidemiol 2010;24:488-91. DOI: https://doi.org/10.1111/j.1365-3016.2010.01139.x
Pinter DM, Mandel J, Hulten KG, Minkoff H, Tosi MF. Maternal-infant perinatal trans-mission of methicillin-resistant and methi-cillin-sensitive Staphylococcus aureus. Am J Perinatol 2009;26:145-51. DOI: https://doi.org/10.1055/s-0028-1095179
Dehority W, Wang E, Vernon PS, Lee C, Perdreau-Remington F, Bradley J. Communi-ty-associated methicillin-resistant Staphylo-coccus aureus necrotizing fasciitis in a neonate. Pediatr Infect Dis J 2006;25:1080-1. DOI: https://doi.org/10.1097/01.inf.0000243158.25713.29
Deurenberg RH, Stobberingh EE. The mo-lecular evolution of hospital- and community-associated methicillin-resistant Staphylococ-cus aureus. Curr Mol Med 2009;9:100-15. DOI: https://doi.org/10.2174/156652409787581637
Diep BA, Otto M. The role of virulence de-terminants in community-associated MRSA pathogenesis. Trends Microbiol 2008;16:361-9. DOI: https://doi.org/10.1016/j.tim.2008.05.002
Bettin A, Suarez P, Bedoya A, Reyes N. [Sta-phylococcus aureus in residents from a nursin-g-home in Cartagena]. Rev Salud Publica (Bo-gota) 2008;10:650-7. DOI: https://doi.org/10.1590/S0124-00642008000400015
Millar BC, Jiru X, Moore JE, Earle JA. A simple and sensitive method to extract bacte-rial, yeast and fungal DNA from blood culture material. J Microbiol Methods 2000;42:139-47. DOI: https://doi.org/10.1016/S0167-7012(00)00174-3
Zhang K, McClure JA, Elsayed S, Louie T, Conly JM. Novel multiplex PCR assay for cha-racterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus. J Clin Microbiol 2005;43:5026-33. DOI: https://doi.org/10.1128/JCM.43.10.5026-5033.2005
Brakstad OG, Aasbakk K, Maeland JA. De-tection of Staphylococcus aureus by polymera-se chain reaction amplification of the nuc gene. J Clin Microbiol 1992;30:1654-60. DOI: https://doi.org/10.1128/jcm.30.7.1654-1660.1992
Lina G, Piemont Y, Godail-Gamot F, et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999;29:1128-32. DOI: https://doi.org/10.1086/313461
Olarte NM, Valderrama IA, Reyes KR, et al. [Methicillin-resistant Staphylococcus aureus colonization in a Colombian hospital intensive care unit: phenotypic and molecular characte-rization.]. Biomedica 2010;30:353-61. DOI: https://doi.org/10.7705/biomedica.v30i3.269
Castro-Orozco R, Villafane-Ferrer LM, Al-varez-Rivera E, De Arco MM, Rambaut-Dona-
do CL, Vitola-Heins GV. [Methicillin-resistant Staphylococcus aureus in children attending school in Cartagena, Colombia]. Rev Salud Pu-blica (Bogota) 2010;12:454-63. DOI: https://doi.org/10.1590/S0124-00642010000300011
Gray J, Patwardhan SC, Martin W. Meticillin-resistant Staphylococcus aureus screening in obstetrics: a review. J Hosp Infect 2010;75:89-92. DOI: https://doi.org/10.1016/j.jhin.2009.11.026
Beigi RH, Bunge K, Song Y, Lee BY. Epi-demiologic and economic effect of methicillin-resistant Staphylococcus aureus in obstetrics. Obstet Gynecol 2009;113:983-91 DOI: https://doi.org/10.1097/AOG.0b013e3181a116e4
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