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Am J Perinatol 2007; 24(4): 235-240
DOI: 10.1055/s-2007-976551
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Predictors and Outcomes for Pregnant Women with Vaginal-Rectal Carriage of Community-Associated Methicillin-Resistant Staphylococcus aureus

Katherine T. Chen1 , 2 , Holly Campbell1 , Luisa N. Borrell2 , Richard C. Huard3 , Lisa Saiman4 , Phyllis Della-Latta3
  • 1Department of Obstetrics and Gynecology, Columbia University, New York, New York
  • 2Department of Epidemiology, Columbia University, New York, New York
  • 3Department of Pathology, Columbia University, New York, New York
  • 4Department of Pediatrics, Columbia University, New York, New York
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Publication History

Publication Date:
19 April 2007 (online)

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ABSTRACT

The purpose of this study was to determine the predictors and outcomes of pregnant women with vaginal-rectal carriage of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). We performed an unmatched 1:4 case-control study with two control groups (13 CA-MRSA cases, 52 methicillin-sensitive S. aureus (MSSA) controls, and 52 S. aureus-negative controls) via a retrospective medical record review. We found that CA-MRSA cases were 12.5 times significantly less likely to be colonized with group B streptococci (GBS) compared with MSSA controls in multivariable analyses. When we compared MSSA patients with S. aureus-negative patients, we found that MSSA patients were 4.5 times significantly more likely to be colonized with GBS and 11 times significantly more likely to have a postpartum fever ≥ 100.4°F in multivariable analyses. Traditional risk factors for hospital-associated MRSA do not appear to predict vaginal-rectal CA-MRSA carriage in pregnant women. Instead, CA-MRSA carriage is significantly associated with lack of GBS carriage. Additional microbiologic studies and epidemiologic studies are needed to clarify the relationship between S. aureus and GBS, given that these two colonizing organisms have the potential to become pathogens.

KEYWORDS

Staphylococcus aureus - methicillin-resistant S. aureus (MRSA) - community-associated MRSA - group B streptococci (GBS) - antibiotic resistance

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Katherine T ChenDepartment of Obstetrics and Gynecology and Epidemiology 

Columbia University

722 West 168th Street, New York, NY 10032

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