Prevalence of methicillin-sensitive and methicillin-resistant Staphylococcus aureus in pregnant women.
OBJECTIVE
To estimate the extent of Staphylococcus aureus vaginal-rectal colonization among pregnant women as severe S aureus infections have emerged in pregnant and postpartum women and infants.


METHODS
We conducted a prospective surveillance study for methicillin-sensitive S aureus and methicillin-resistant S aureus on all routine de-identified vaginal-rectal prenatal group B streptococcus (GBS) screening cultures submitted to the microbiology laboratory of a tertiary-care facility from January to July 2005. Standard microbiologic techniques and molecular analyses were used to detect community-associated methicillin-resistant S aureus strains. As opposed to health care-associated methicillin-resistant S aureus isolates, community-associated methicillin-resistant S aureus isolates were defined as those possessing the type IV or type V staphylococcal chromosomal cassette mec element and usually lacking a multidrug-resistant phenotype.


RESULTS
A total of 2,963 GBS screening cultures were analyzed, from which 743 (25.1%, 95% confidence interval [CI] 23.5-26.7%) GBS isolates and 507 (17.1%, 95% CI 15.7-18.5%) S aureus isolates were identified. Group B streptococcus colonization was significantly associated with S aureus colonization (prevalence odds ratio 2.1, 95% CI 1.7-2.5, P < .001). Of the S aureus isolates, 14 (2.8%, 95% CI 1.4-4.2%) were methicillin-resistant, and 13 of these were determined to be community-associated methicillin-resistant S aureus.


CONCLUSIONS
The prevalence of S aureus colonization identified in GBS screening cultures from pregnant women was substantial and associated with GBS co-colonization. Although we do not advocate routine screening of pregnant women for methicillin-sensitive S aureus and methicillin-resistant S aureus colonization, we recommend continued monitoring of both methicillin-sensitive S aureus and methicillin-resistant S aureus infections in this population and their infants.
Chen
Katherine T
KT
Department of Obstetrics and Gynecology and Epidemiology, Columbia University, New York, New York 10032, USA. ktc10@columbia.edu
Huard
Richard C
RC
Della-Latta
Phyllis
P
Saiman
Lisa
L
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008403:Mass Screening; D008712:Methicillin / Q000494:pharmacology* / Q000627:therapeutic use; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009518:New York / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000187:drug effects; D014621:Vagina / Q000382:microbiology
D000900:Anti-Bacterial Agents; D008712:Methicillin