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Association between Maternal Urine Cultures and ESBL-PE in Neonates

This study explores the association between the presence of Extended-Spectrum-β-Lactamase-producing Enterobacteriaceae (ESBL-PE) in gestational urine cultures and ESBL-PE in corresponding neonatal cultures. It also examines the impact of ESBL-PE on neonatal morbidity and mortality.

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Association between Maternal Urine Cultures and ESBL-PE in Neonates

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  1. Extended-Spectrum-β-Lactamase producing Enterobacteriaceae in neonates and association with maternal urine cultures. Alex Guri1, Natalie Flaks-Manov2, Adi Ghilai2, Moshe Hoshen2, Ariel Benis2, Orna Flidel3, Pnina Ciobotaru4, Oren Zimhony4 Division of Pediatrics, Kaplan Medical Centre, Rehovot, Israel Clalit Research Institute, Chief Physician's Office, Clalit Health Services, Tel Aviv Neonatology Department, Kaplan Medical Centre, Rehovot, Israel Infectious Diseases Unit, Kaplan Medical Centre, Rehovot, Israel

  2. Disclosure

  3. Background Community acquired Extended Spectrum β-Lactamase producing Enterobacteriaceae (ESBL-PE) pandemics, 1990s-today Enterobacteriaceae (EB) cause early and late onset neonatal sepsis The burden of EB sepsis is especially high in Neonatal Intensive Care Units (NICU)

  4. Woerther, P. L., (2013). Trends in human fecal carriage of extended-spectrum β-lactamases in the community: toward the globalization of CTX-M. Clinical microbiology reviews, 26(4), 744-758.

  5. Woerther, P. L., (2013). Trends in human fecal carriage of extended-spectrum β-lactamases in the community: toward the globalization of CTX-M. Clinical microbiology reviews, 26(4), 744-758. ESBL-PE carriage in the community according to their geographical and temporal distribution

  6. Background Routine urinary cultures are taken during pregnancy Treatment of asymptomatic bacteriuria in pregnancy prevents pyelonephritis and premature labour No data about the significance of these cultures for vertical transmission to neonates

  7. Objectives Primary - to find out association between the presence of ESBL-PE in gestational urine cultures and ESBL-PE in the corresponding neonates' cultures Secondary - to analyze the effect of ESBL-PE on neonatal morbidity and mortality

  8. Methods Retrospective cohort study of neonates born during the years 2009-2013 whose mothers had performed urinary cultures within one year prior to delivery Data were obtained from the centralized Clalit Health Services warehouse The cohort included only neonates who had any type of positive EB culture during the first three months after birth

  9. Results Flowchart of the Study Population

  10. Trends for ESBL-PE proportion in the EB positive neonatal cultures (n=2,647) Total rate for 5 years cohort = 11%

  11. Primary Objective

  12. Secondary Objective 1 Neonates length of hospital stay during the 3 months after birth

  13. Secondary Objective 2

  14. Conclusions ESBL-PE in maternal urinary culture during pregnancy is an independent risk for neonatal ESBL-PE Neonatal ESBL-PE are associated with increased hospital stay and mortality Comprehensive infection control policy in NICU should take in consideration the results of maternal urinary cultures

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