母亲和新生儿MRSA筛检，未必能降低获得性MRSA定植

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文章：Volk L. Infect Control Hosp Epidemiol. 2011;doi:10.1086/662018.
Widespread maternal and newborn screening for methicillin-resistant Staphylococcus aureus colonization may not be warranted due to low colonization rates among pregnant women and the lack of invasive disease from colonization in either the mother or her newborn infant, according to Lauze Volk, MD, and colleagues.
In a study published inInfection Control and Hospital Epidemiology, Volk, of the department of pediatrics at Loyola University Medical Center, and colleagues examined the incidence of nasal MRSA colonization among pregnant women (n=1,819) and the incidence of transmission to their newborns
Women were admitted to labor and delivery and their newborn infants admitted to the nursery in a 571-bed tertiary care academic institution between Dec. 1, 2007, and Aug. 31, 2009. No MRSA-related complications occurred among 23 pregnant women; no cases of MRSA bacteremia or invasive disease occurred among newborn infants admitted to the nursery during the study period.
MRSA nasal colonization, route of delivery and presence or absence of skin or soft tissue lesions suggestive of MRSA infection were assessed among women with positive MRSA colonization (n=39). Thirteen women colonized with MRSA had a cesarean section, of which, two women acquired MRSA infection; one was admitted with a facial abscess; and another woman treated with perioperative vancomycin prophylaxis had “a presumptive wound infection 18 days after surgery.”
Four infants tested positive for nasal MRSA colonization. One infant who tested positive for MRSA nasal carriage was born to a mother who did not have a positive MRSA test but did have a perineal abscess at the time of admission that was presumed to be MRSA, according to the researchers.
“Nasal MRSA colonization rates among pregnant women in our institution were much lower than those of our general adult population (2% vs. 7%),” the researchers wrote. “Additionally, despite the low colonization rate among newborn infants overall, there is a strong association between maternal nasal MRSA colonization and that of their newborn infants. Our data also revealed that universal surveillance did not have any significant impact on either perioperative prophylaxis of women undergoing cesarean section delivery or the development of MRSA disease in the postpartum period.”

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