title: Transmission of Staphylococcus aureus between mothers and infants in an African setting.
abstract: Staphylococcus aureus colonization is a risk factor for invasive disease. There is a need to understand S. aureus colonization in infancy as the burden of S. aureus infections in infants is high. We aimed to investigate the transmission of S. aureus between mothers and their newborns during the first year after delivery in an African setting. In a longitudinal cohort study, colonization of Gabonese mother-infant pairs was assessed at delivery and after 1, 9 and 12 months. Swabs were taken from mothers (nares, mammillae) and infants (nares and throat). Isolates were characterized and risk factors for colonization were assessed using a standardized questionnaire. We recruited 311 mothers and 318 infants including seven sets of twins. Maternal and infant colonization rates declined synchronously following a peak after 1 month at 40% (mothers) and 42% (infants). Maternal colonization was a risk factor for S. aureus carriage in infants. Based on spa typing, direct mother-to-infant transmission was evident in 5.6%. Of all methicillin-resistant isolates (n = 9), 44.4% were related to the USA300 clone; 56.7% (n = 261) of all S. aureus carried Panton-Valentine leukocidin encoding genes. Direct mother-to-infant transmission was rare and cannot explain the increase of carriage in infants within the first month. A transmission from external sources is likely and challenges the S. aureus infection control in newborns and infants in an African setting. The detection of USA300-related MRSA fuels the concern about the spread of this clone in Central Africa.
authors.affiliation: Institute of Medical Microbiology, University Hospital Münster, Münster, Germany; Centre de Recherches Médicales de Lambaréné, Albert Schweitzer Hospital, Lambaréné, Gabon.
authors.forename: F
authors.initials: F
authors.lastname: Schaumburg
authors.forename: A S
authors.initials: AS
authors.lastname: Alabi
authors.forename: G
authors.initials: G
authors.lastname: Mombo-Ngoma
authors.forename: H
authors.initials: H
authors.lastname: Kaba
authors.forename: R M
authors.initials: RM
authors.lastname: Zoleko
authors.forename: D A
authors.initials: DA
authors.lastname: Diop
authors.forename: J-R
authors.initials: JR
authors.lastname: Mackanga
authors.forename: A
authors.initials: A
authors.lastname: Basra
authors.forename: R
authors.initials: R
authors.lastname: Gonzalez
authors.forename: C
authors.initials: C
authors.lastname: Menendez
authors.forename: M P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: P G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: R
authors.initials: R
authors.lastname: Köck
authors.forename: G
authors.initials: G
authors.lastname: Peters
authors.forename: M
authors.initials: M
authors.lastname: Ramharter
authors.forename: K
authors.initials: K
authors.lastname: Becker
mesh_terms: D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission*; D015331:Cohort Studies; D005098:Exotoxins / Q000235:genetics; D005260:Female; D005681:Gabon / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007956:Leukocidins / Q000235:genetics; D008137:Longitudinal Studies; D008297:Male; D058889:Molecular Typing; D011247:Pregnancy; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission*; D013211:Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin
keywords: Africa; Staphylococcus aureus; USA300; infancy; transmission