Dynamics of the digestive acquisition of bacterial carriage and integron presence by French preterm newborns according to maternal colonization: The DAIR3N multicentric study

Frontiers in Microbiology

Microbiology

Philippe Lehours¹  Damien Dubois²  Melinda Benard³  Philippe Jouvencel⁴  Laure Ponthier⁵  Antoine Bedu⁵  Philippe Bothorel⁵  Laurent Renesme⁶  Karine Norbert⁷  Anaïs Labrunie⁸  Sandrine Luce⁸  Delphine Chainier⁹  Alice Patry⁹  Sylvain Meyer⁹  Carole Grélaud⁹  Marie-Cecile Ploy⁹  Fabien Garnier⁹  Laurent Villeneuve^1,10  David Leysenne^1,11 

[1] Bacteriology Laboratory, Pellegrin University Hospital, Bordeaux, France;Bacteriology and Hygiene Department, Federative Institute of Biology, CHU Toulouse University Hospital, Toulouse, France;Department of Pediatrics and Neonatology, CHU Toulouse, Toulouse, France;Department of Pediatrics and Neonatology, « Côte Basque » Hospital, Bayonne, France;Department of Pediatrics, Mother-Child Hospital, Limoges University Hospital, Limoges, France;Department of Pediatrics, Neonatology and Maternity Unit, Pellegrin University Hospital, Bordeaux, France;Department of Pediatrics, Pau Hospital, Pau, France;Epidemiology, Biostatistics, and Research Methodology Centre (CEBIMER), Limoges University Hospital, Limoges, France;INSERM UMR, Limoges University, Limoges University Hospital, Limoges, France;Medical Biology Laboratory, Pau Hospital, Pau, France;Microbiology Laboratory, « Côte Basque » Hospital, Bayonne, France;

关键词: Integrons;    digestive acquisition;    antimicrobial resistance;    preterm newborn infant;    resistance markers;    gram-negative bacteria;   

DOI  :  10.3389/fmicb.2023.1148319

 received in 2023-01-19, accepted in 2023-02-21,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesThe study aimed to describe the dynamics and risk factors of Gram-negative bacteria (GNB) acquisition in preterm infants.MethodsThis prospective multicenter French study included mothers hospitalized for preterm delivery and their newborns, followed until hospital discharge. Maternal feces and vaginal fluids at delivery, and neonatal feces from birth to discharge were tested for cultivable GNB, potential acquired resistance, and integrons. The primary outcome was the acquisition of GNB and integrons in neonatal feces, and their dynamics, evaluated by survival analysis using the actuarial method. Risk factors were analyzed using Cox models.ResultsTwo hundred thirty-eight evaluable preterm dyads were included by five different centers over 16 months. GNB were isolated in 32.6% of vaginal samples, with 15.4% of strains producing extended-spectrum beta-lactamase (ESBL) or hyperproducing cephalosporinase (HCase), and in 96.2% of maternal feces, with 7.8% ESBL-GNB or HCase-GNB. Integrons were detected in 40.2% of feces and 10.6% of GNB strains. The mean (SD) length of stay of newborns was 39.5 (15.9) days; 4 died in the hospital. At least one infection episode occurred in 36.1% of newborns. The acquisition of GNB and integrons was progressive from birth to discharge. At discharge, half of newborns had ESBL-GNB or HCase-GNB, independently favored by a premature rupture of membranes (Hazard Ratio (HR), 3.41, 95% confidence interval (CI), 1.71; 6.81), and 25.6% had integrons (protective factor: multiple gestation, HR, 0.367, 95% CI, 0.195; 0.693).ConclusionIn preterm newborns, the acquisitions of GNB, including resistant ones, and integrons are progressive from birth to discharge. A premature rupture of membranes favored the colonization by ESBL-GNB or Hcase-GNB.

【 授权许可】

Unknown   
Copyright © 2023 Patry, Bothorel, Labrunie, Renesm, Lehours, Benard, Dubois, Ponthier, Meyer, Norbert, Villeneuve, Jouvencel, Leysenne, Chainier, Luce, Grélaud, Ploy, Bedu and Garnier.