Comparison of FT-IR with whole-genome sequencing for identification of maternal-to­neonate transmission of antibiotic-resistant bacteria.

Following a previous study in which we evaluated the carriage rates of extended spectrum ß-lactamase (ESBL) -producing Enterobacterales (ESBL+ E), carbapenem-resistant Enterobacterales (CRE), vancomycin-resistant Enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) among pregnant women and their neonates, in the current study we used, for the first time, Fourier transform infrared spectrometry (FT-IR) in order to determine whether antibiotic-resistant bacteria colonization in neonates has resulted from a vertical transmission from the mothers. To this end, 28 pairs of maternal and neonatal isolates of antibiotic-resistant bacteria, including ESBL-producing E. coli (ESBL+E.coli), ESBL-producing K. pneumoniae (ESBL+K. pneumoniae) and MRSA isolates, were subjected to a FT-IR analysis to assess the similarity between maternal and new-born isolates. We compared the FT-IR analysis results with whole genome sequencing of the isolates, in order to define whether FT-IR spectroscopy can be applied for bio-typing of bacteria and for assessment of mother-to­neonate transmission. The FT-IR analysis showed that all neonatal isolates were similar to their corresponding maternal isolates and belonged to the same cluster. Alignments of the DNA sequences of the maternal and neonatal isolates pairs revealed above 99% identity, thus confirming the FT-IR results. In conclusion, FT-IR spectroscopy can be applied to monitor bacterial transmission and specifically maternal-to­neonate transmission.

Mother-to-Neonate Transmission of Antibiotic-Resistant Bacteria: A Cross-Sectional Study.

We evaluated carriage rates of extended spectrum ß-lactam-producing Enterobacterales (ESBL-E), Carbapeneme-resistant Enterobacterales (CRE), vancomycin-resistant Enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) among pregnant women and determined the maternal-to-neonate transmission rates of these antibiotic-resistant bacteria (ARB). Pregnant women provided rectal and vaginal samples, proximal to delivery. Stool samples were collected from newborns within 48 h of birth. All samples were cultured on selective media for ARB identification. Clinical and demographic data were collected from the participants' medical files. We performed molecular and phenotypic characterization of the different resistance mechanisms, and determined the isolates' antibiotic susceptibility and biofilm-forming ability. The prevalence of ESBL-E, MRSA and VRE among pregnant women were 16%, 6% and 1%, respectively. The prevalence of ESBL-E and MRSA among neonates were 7.6% and 1.6%, respectively. Maternal-to-neonate transmission rates of ESBL-E and MRSA were 48% and 27.8%, respectively. Maternal and neonatal isolates shared similar characteristics. Maternal-to-neonate transmission of ARB plays an important role in bacterial colonization in newborns. Future studies should investigate the outcomes of the high ESBL-E transmission rate. The biofilm-forming ability of ARB was found to affect transmission. Additional factors should be investigated in order to understand the differences between transmitted and non-transmitted bacteria.