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403 Methicillin- resistant Staphylococcus aureus (MRSA) Colonization Rates among Pregnant Women Admitted to Labor and Delivery and their Newborn Infants

Saturday, March 20, 2010: 11:00 AM
International North (Hyatt Regency Atlanta)
Pankaj Chhangani, MD , Loyola University Medical Center, Maywood, IL
Laura Digangi, BA , Loyola University Medical Center, Maywood, IL
Jorge P. Parada, MD, MPH , Loyola University Medical Center, Maywood, IL
Paul Schrekenberger, PHD , Loyola University Medical Center, Maywood, IL
Violet Rekasius, MT, (, ASCP) , Loyola University Medical Center, Maywood, IL
Lauze Volk, MD , Loyola University Medical Center, Maywood, IL
Malliswari Challapalli, MD , Loyola University Medical Center, Maywood, IL
Background: Community-associated Methicillin Resistant Staphylococcus aureus (CA-MRSA) infections are increasing in frequency. Nasal MRSA colonization rates amongst pregnant women and the incidence of MRSA transmission to newborn infants is not well characterized. 

Objective: To determine the incidence of nasal MRSA colonization rates amongst pregnant women and the incidence of transmission to the newborns of colonized mothers.

Methods: All pregnant women admitted to Labor and Delivery (L & D) and their newborn infants admitted to nursery from 12/1/07 to 8/31/09 were screened for nasal MRSA colonization by using the Cepheid GeneXpert rapid PCR. Microbiology laboratory data were also reviewed to detect any MRSA invasive infections in newborn infants less than 48 hours of age.

Results: A total of 2254 pregnant women were admitted to L & D from 12/1/07 to 8/31/09. Nasal MRSA surveillance screens were ordered in 1819 (compliance rate of 81%). 39 of the 1819 pregnant women screened were positive for MRSA colonization (2.14%). 31 of the pregnant women with MRSA nasal colonization delivered and 3 of their newborn infants were also colonized with MRSA (9.7%). Overall, 4 (0.2%) newborn infants were positive for nasal MRSA colonization. The 4th colonized newborn was born to a woman with negative nasal MRSA colonization however she had an uncultured perineal abscess. In addition there were no cases of MRSA bacteremia or invasive disease among newborn infants admitted to our nursery from 12/07 through 08/09.

Conclusions: Our data shows that the nasal MRSA colonization amongst pregnant women is 2.14 % which is about 1/3rd of that of the general hospitalized population (7% at our hospital). It also shows that there is a strong association between maternal nasal MRSA colonization and that of their newborn infants. However, as there is also no evidence of invasive disease in either group this suggests that widespread maternal and newborn screening strategies may not be warranted at this time.