Transmission of Staphylococcus aureus between mothers and infants in an African setting

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 firs...

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Published in:	Clinical microbiology and infection Vol. 20; no. 6; pp. O390 - O396
Main Authors:	Schaumburg, F., Alabi, A.S., Mombo-Ngoma, G., Kaba, H., Zoleko, R.M., Diop, D.A., Mackanga, J.-R., Basra, A., Gonzalez, R., Menendez, C., Grobusch, M.P., Kremsner, P.G., Köck, R., Peters, G., Ramharter, M., Becker, K.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-06-2014 Elsevier Limited
Subjects:	Adolescent Adult Africa Bacterial Toxins - genetics Carrier State - epidemiology Carrier State - microbiology Carrier State - transmission Cohort Studies Exotoxins - genetics Female Gabon - epidemiology Genotype Humans infancy Infant Infant, Newborn Infectious Disease Transmission, Vertical Leukocidins - genetics Longitudinal Studies Male Molecular Typing Pregnancy Prevalence Staphylococcal Infections - epidemiology Staphylococcal Infections - microbiology Staphylococcal Infections - transmission Staphylococcus aureus Staphylococcus aureus - classification Staphylococcus aureus - genetics Staphylococcus aureus - isolation & purification transmission USA300 Young Adult Gabon infancy transmission USA300 Staphylococcus aureus Africa
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1198-743X 1469-0691
DOI:	10.1111/1469-0691.12417