title: Screening for Staphylococcus aureus carriage in pregnancy: usefulness of novel sampling and culture strategies.
abstract: OBJECTIVE
  The purpose of this study was to determine the most sensitive strategy for the detection of Staphylococcus aureus among pregnant women and newborn infants.
  
  
  METHODS
  We obtained cultures for S aureus from 5 body sites of women at 35-37 weeks' gestation. We obtained cultures from their newborn infants before hospital discharge.
  
  
  RESULTS
  Of 209 women who were screened, 29% of the women had at least 1 culture that was positive for S aureus; 5% of infants were S aureus carriers. The sensitivities of each site for S aureus detection were 52% nares, 50% throat, 13% rectum, 8% vagina, and 10% skin. The most sensitive combination of 2 sites was nares and throat (88%). Perinatal transmission of S aureus occurred in 4 women. Maternal methicillin-resistant S aureus carriage rate was 1%. Two infants carried the USA300 methicillin-resistant S aureus.
  
  
  CONCLUSIONS
  Screening single body sites is insensitive for the detection of S aureus carriage in pregnancy. Sampling nares and throat is essential to the identification of S aureus carriers.
authors.affiliation: Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City, IA, USA.
authors.forename: Janet I
authors.initials: JI
authors.lastname: Andrews
authors.forename: Diedre K
authors.initials: DK
authors.lastname: Fleener
authors.forename: Shawn A
authors.initials: SA
authors.lastname: Messer
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Kroeger
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Diekema
mesh_terms: D002353:Carrier State; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009666:Nose / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013211:Staphylococcus aureus / Q000302:isolation & purification