title: Evaluation of existence and transmission of extended spectrum beta lactamase producing bacteria from post-delivery women to neonates at Bugando Medical Center, Mwanza-Tanzania.
abstract: BACKGROUND
  Extended spectrum beta-lactamase producing bacteria (ESBL) are common causes of neonatal sepsis worldwide. Neonatal sepsis due to ESBL is associated with increased morbidity and mortality at Bugando Medical Centre (BMC). Due to limited information on the sources of these ESBL strains at BMC, this study was conducted to evaluate the existence, magnitude and transmission of ESBL from post-delivery women to neonates at BMC, Mwanza-Tanzania.
  
  
  RESULTS
  A cross-sectional study was conducted at obstetrics and neonatal wards from May to July 2013, involving post-delivery women and their neonates. Rectal swabs were collected and processed to identify the ESBL strains and their antimicrobial susceptibility patterns. Patients' data were obtained using a standardized data collection tool. We enrolled 113 women and 126 neonates with mean age of 26.5 ± 5.5 years and median gestation age [IQR] of 39 [35-40] weeks respectively. The prevalence of ESBL carriage among women and neonates were 15% (17/113) and 25.4% (32/126) respectively. The acquisition of ESBL isolates among neonates on day 1, day 3 and day 7 were 60.0% (21/35), 25.7% (9/35) and 14.3% (5/35) respectively. There was no phenotypic similarity between ESBL strains from women and their respective neonates, suggesting other sources of transmission. Neonates given antibiotics were more likely to carry ESBL than those not given [100% (32/32) versus 86% (81/94), p = 0.018].
  
  
  CONCLUSIONS
  The carriage rate of ESBL strains among post-delivery women and neonates at BMC is high. Our findings suggest that neonates acquire these strains from sources other than post-delivery women and more than half acquire them on the first day of life. More studies are recommended to further explore the sources of ESBL strains among neonates.
authors.forename: Edwin
authors.initials: E
authors.lastname: Nelson
authors.forename: Juma
authors.initials: J
authors.lastname: Kayega
authors.affiliation: Department of Microbiology/Immunology, Catholic University of Health and Allied Sciences, P,O, Box 1464, Mwanza, Tanzania. senijj80@gmail.com.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Seni
authors.forename: Martha F
authors.initials: MF
authors.lastname: Mushi
authors.forename: Benson R
authors.initials: BR
authors.lastname: Kidenya
authors.forename: Adolfine
authors.initials: A
authors.lastname: Hokororo
authors.forename: Antke
authors.initials: A
authors.lastname: Zuechner
authors.forename: Albert
authors.initials: A
authors.lastname: Kihunrwa
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Mshana
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001419:Bacteria / Q000201:enzymology* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D002353:Carrier State / Q000382:microbiology / Q000635:transmission; D036861:Delivery, Obstetric; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D013636:Tanzania; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases