2023 Fiscal Year Final Research Report
Maternal-neonatal transmission of extended-spectrum b-lactamase-producing enterobacteriaceae
| Project/Area Number |
19K17299
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 52050:Embryonic medicine and pediatrics-related
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| Research Institution | Shimane University |
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Principal Investigator |
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Keywords | 基質拡張型β-ラクタマーゼ産生大腸菌 / 薬剤耐性菌 / 母子感染 / 院内感染 / 家庭内感染 |
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| Outline of Final Research Achievements |
The increase in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBL-E) has become a global issue. The route of transmission of ESBL-E to infants remain unknown. This study aimed to determine whether ESBL-E can be transmitted from the mother to the neonate.
In this cross-sectional prospective study, we collected rectal samples from neonates who were born with normal gestational age in our hospital from September 2019 to December 2020. We compared the results from the neonatal and maternal cultures. This study included 631 neonates and 629 mothers. Among them, ESBL-E strains were isolated from 31 neonates (4.9%) and 25 pregnant women (4.0%). The ESBL-E transmission rates to the neonates were 32%, 45%, and 23% for the vertical, nosocomial, and household transmissions, respectively.
Maternal carrier status was associated with an increased risk of ESBL-E transmission to the neonates. Nosocomial or domestic transmission is another potential transmission route of ESBL-E.
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| Free Research Field |
小児感染症
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| Academic Significance and Societal Importance of the Research Achievements |
薬剤耐性菌の増加は世界中で問題となっている。特に基質拡張型β-ラクタマーゼ産生大腸菌（ESBL-E）は、小児において尿路感染症や髄膜炎などの重要な原因菌となっている。これまで乳幼児へのESBL-E感染ルートは明らかになっておらず、主な感染ルートとして母子感染が示唆された。
今回の研究では、新生児期に既に多くのESBL-E感染を認め、母子感染は重要な感染ルートであった。しかし、院内感染や家庭内感染も重要な感染ルートであった。
そのため、新生児へのESBL-E感染を抑制するために、ESBL-Eを保菌する母親への指導、院内感染対策の強化、手指衛生など家庭内での感染対策の強化が重要となる。
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