Skip Navigation LinksHome > January 2008 - Volume 111 - Issue 1 > Genital Tract Methicillin-Resistant Staphylococcus aureus: R...
Obstetrics & Gynecology:
doi: 10.1097/01.AOG.0000298344.04916.11
Original Research

Genital Tract Methicillin-Resistant Staphylococcus aureus: Risk of Vertical Transmission in Pregnant Women

Andrews, William W. PhD, MD1; Schelonka, Robert MD2; Waites, Ken MD3; Stamm, Alan MD4; Cliver, Suzanne P.1; Moser, Stephen PhD3

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Abstract

OBJECTIVE: To estimate the frequency of genital tract colonization by methicillin-resistant Staphylococcus aureus (MRSA) among pregnant women and evaluate the association of such colonization with infant outcome.

METHODS: Between July 2003 and July 2006, anovaginal screening cultures for group B Streptococcus (GBS) were prospectively obtained in the third trimester (35 to less than 37 weeks of gestation) and were also processed for identification of Staphylococcus aureus including methicillin-resistant strains. Maternal colonization by MRSA was linked to a computerized database of invasive neonatal infections that occurred at our center during the study period.

RESULTS: Among 5,732 mothers (who delivered 5,804 infants) with GBS screening cultures and infant infection data available, 22.9% were GBS-positive and 14.5% were positive for Staphylococcus aureus. A total of 24.3% of the Staphylococcus aureus isolates were MRSA. The overall MRSA colonization rate was 3.5%. Colonization by any Staphylococcus aureus (relative risk 1.6, 95% confidence interval 1.4–1.9) as well as MRSA (relative risk 2.2, 95% confidence interval 1.6–2.8) was significantly more common among GBS-positive than among GBS-negative women. No cases of early-onset invasive neonatal infection by MRSA occurred among infants in the study.

CONCLUSION: Genital tract colonization with MRSA affected 3.5% of pregnant women. Such MRSA colonization is associated with colonization by GBS but does not predispose to a high risk of early-onset neonatal MRSA infection.

LEVEL OF EVIDENCE: III

© 2008 by The American College of Obstetricians and Gynecologists.

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