Abstract
494: Screening for staphylococcus aureus carriage in pregnancy: Utility of novel sampling and culture strategies
American journal of obstetrics and gynecology, Vol.199(6 Supplement A), pp.S146-S146
2008
DOI: 10.1016/j.ajog.2008.09.523
Abstract
Objective
Screening for S. aureus (including methicillin resistant S. aureus (MRSA)) carriage is increasingly common as part of epidemiologic studies and prevention programs. We sought to determine the most sensitive strategy for detection of S. aureus carriage among pregnant women and their newborns.
Study Design
We performed cultures for S. aureus carriage from nares, throat, skin, vagina and rectum of women at 35-37 weeks gestation. We also cultured their infants (nares and umbilicus) prior to hospital discharge. Standard culture methods, including broth enrichment, were used. Antimicrobial susceptibility and pulsed field gel electrophoresis (PFGE) was performed for all S. aureus isolates.
Results
Of 101 women screened, 33 (33%) had at least one culture positive for S. aureus, while 6 (6%) of 101 infants were S. aureus carriers. The sensitivities of each single site for detection of S. aureus carriage among pregnant women were 51% nares, 45% throat, 15% rectum, 9% vagina, and 9% skin. The most sensitive combination of 2 sites was nares and throat (88%). Of the 6 infant carriers, 5 (83%) had positive umbilical cultures, and only 2 had positive nares cultures. PFGE typing of the 3 mother-infant pairs carrying S. aureus indicated each pair shared an identical strain. Only 2 of 33 S. aureus were methicillin resistant (MRSA), for an overall maternal MRSA carriage rate of 2%. One infant carried MRSA. Of the 39 women and infants with S. aureus carriage, 16 (41%) were detected only in broth enrichment cultures. Using the current standard approach to S. aureus screening (nares culture only, without broth enrichment), fewer than half of S. aureus carriers would have been detected.
Conclusion
Screening single body sites (e.g. nares) is insufficiently sensitive for detection of S. aureus carriage among pregnant women. Sampling nares and throat, using broth enrichment, is essential to identify S. aureus carriers.
Details
- Title: Subtitle
- 494: Screening for staphylococcus aureus carriage in pregnancy: Utility of novel sampling and culture strategies
- Creators
- Janet Andrews - University of IowaDiedre Fleener - University of IowaShawn Messer - University of IowaDaniel Diekema - University of Iowa
- Resource Type
- Abstract
- Publication Details
- American journal of obstetrics and gynecology, Vol.199(6 Supplement A), pp.S146-S146
- Publisher
- Mosby, Inc
- DOI
- 10.1016/j.ajog.2008.09.523
- ISSN
- 0002-9378
- eISSN
- 1097-6868
- Language
- English
- Date published
- 2008
- Academic Unit
- Pathology; Obstetrics and Gynecology; Infectious Diseases; Internal Medicine
- Record Identifier
- 9984697137202771
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