CORRELATION BETWEEN MATERNAL VAGINA ESBL-COLONIZATION AND EARLY ONSET NEONATAL SEPSIS IN A TERTIARY HOSPITAL IN LAGOS, NIGERIA

Abstract

GOAL: Extended spectrum β-lactamases (ESBL) is a group of enzymes that confer resistance to
all third generation cephalosporins and aztreonam but not carbapenems and they are inhibited by
β-lactamase inhibitors such as clavulanic acid. This study aims To determine whether or
otherwise a correlation exists between maternal vaginal colonization with extended spectrum β
lactamases producing Enterobacteriaceae and early onset neonatal sepsis, among pregnant
women at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, using Eschericia
coli and Klebsiella pneumonia as surrogates.
SUBJECTS AND METHODS: High vaginal swabs was collected from consented 350 pregnant
women and body surfaces swabs were collected from their newborn babies as soon as they were
delivered. After an overnight culture, antibiotic susceptibility testing, ESBL screening and
confirmation were done on isolates of Enterobacteriaceae. Babies colonized by
Enterobacteriaceae were observed for seven days for signs and symptoms of sepsis. Blood
culture was done on babies suspected of sepsis, followed by antibiotic susceptibility testing,
ESBL screening and confirmation. Clonal mother to newborn transmission of infection was
established by comparison of antibiogram and plasmid genes array of Enterobacteriaceae blood
isolates of babies with vagina colonizing isolates of their mothers.
RESULTS: Maternal vagina and newborn body surfaces ESBL carriage rate of 16% was
recorded. The antibiotic susceptibility pattern was the same for isolates colonizing the maternal
vagina and newborn body surfaces with imipenem recording the highest susceptibility of 99.2%
and amoxicillin clavulanate the least value of 53.1%.This study could not establish a correlation
between maternal vagina ESBL colonization and ESBL-linked early onset neonatal sepsis.
CONCLUSION: Antenatal ESBL screening is only advised in ESBL endemic areas.

CORRELATION BETWEEN MATERNAL VAGINA ESBL-COLONIZATION AND EARLY ONSET NEONATAL SEPSIS IN A TERTIARY HOSPITAL IN LAGOS, NIGERIA