Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2025-01-01T00:09:47.909Z Has data issue: false hasContentIssue false
  • English
  • Français

Transmission of Methicillin-Resistant Staphylococcus aureus to Preterm Infants Through Breast Milk

Published online by Cambridge University Press:  02 January 2015

Priya Behari ,
Janet Englund ,
Grace Alcasid ,
Sylvia Garcia-Houchins  and
Stephen G. Weber
Priya Behari
Affiliation:
Section of Infectious Diseases, University of Chicago, Chicago, Illinois
Janet Englund
Affiliation:
Section of Pediatric Infectious Diseases, University of Chicago, Chicago, Illinois
Grace Alcasid
Affiliation:
Infection Control Program, University of Chicago, Chicago, Illinois
Sylvia Garcia-Houchins
Affiliation:
Infection Control Program, University of Chicago, Chicago, Illinois
Stephen G. Weber*
Affiliation:
Section of Infectious Diseases, University of Chicago, Chicago, Illinois Infection Control Program, University of Chicago, Chicago, Illinois
*
University of Chicago, 5841 S. Maryland Avenue MC 5065, Chicago, IL 60637-1463
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine a potential source of MRSA colonization and infection among preterm infants in a neonatal intensive care unit (NICU) using molecular analysis of breast milk samples.

Design:

Case report, outbreak investigation.

Results:

Preterm triplets were delivered at 26 weeks' gestation via cesarean section when routine active surveillance for MRSA was performed for all infants in a NICU. Surveillance consisted of swabbing the throat, nose, and umbilicus (TNU) weekly. Although infants A and B initially had negative TNU swabs, repeat cultures were positive for MRSA on day of life (DOL) 10 and DOL 18, respectively. Surveillance and clinical cultures for infant C were negative. Infant A developed sepsis, and multiple blood cultures were positive for MRSA beginning on DOL 14. Infant B developed conjunctivitis and a conjunctival exudate culture was positive for MRSA on DOL 70. Both infants were fed breast milk via nasogastric tube. Cultures of breast milk samples for infants A and B dated prior to either infant's first positive surveillance culture were positive for MRSA. All MRSA isolates had identical results on antibiotic susceptibility testing. PFGE demonstrated identical banding patterns for the MRSA isolates from the blood culture of infant A, breast milk for infants A and B, and a surveillance swab from infant B. At no time did the mother develop evidence of mastitis or other local breast infection.

Conclusions:

MRSA can be passed from mother to preterm infant through contaminated breast milk, even in the absence of maternal infection. Colonization and clinical disease can result.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 778 - 780
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Graham, DR, Correa-Villasenor, A, Anderson, RL, Vollman, JH, Baine, WB. Epidemic neonatal gentamicin-methicillin-resistant Staphylococcus aureus infection associated with nonspecific topical use of gentamicin. J Pediatr 1980;97:972–978.Google Scholar
2.Davies, EA, Emmerson, AM, Hogg, GM, Patterson, MF, Shields, MD. An outbreak of infection with a methicillin-resistant Staphylococcus aureus in a special care baby unit: value of topical mupirocin and of traditional methods of infection control. J Hosp Infect 1987;10:120–128.Google Scholar
3.Morel, AS, Wu, F, Della-Latta, P, Cronquist, A, Rubenstein, D, Saiman, L. Nosocomial transmission of methicillin-resistant Staphylococcus aureus from a mother to her preterm quadruplet infants. Am J Infect Control 2002;30:170–173.Google Scholar
4.Novak, FR, Da Silva, AV, Hagler, AN, Figueiredo, AM. Contamination of expressed human breast milk with an epidemic multiresistant Staphylococcus aureus clone. J Med Microbiol 2000;49:1109–1117.Google Scholar
5.Jernigan, JA, Titus, MG, Groschel, DH, Getchell-White, S, Farr, BM. Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol 1996;143:496–504.Google Scholar
6.Le Thomas, I, Mariani-Kurkdjian, P, Collignon, A, et al.Breast milk transmission of a Panton-Valentine leukocidin-producing Staphylococcus aureus strain causing infantile pneumonia. J Clin Microbiol 2001;39:728–729.Google Scholar
7.Raymond, J, Bingen, E, Brahimi, N, et al.Staphylococcal scalded skin syndrome in a neonate. Eur J Clin Microbiol Infect Dis 1997;16:453–454.Google Scholar
8.Muder, RR, Brennen, C, Wagener, MM, et al.Methicillin-resistant staphylococcal colonization and infection in a long-term care facility. Ann Intern Med 1991;114:107–112.Google Scholar
9.Campbell, JR, Zaccaria, E, Mason, EO Jr, Baker, CJ. Epidemiological analysis defining concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Infect Control Hosp Epidemiol 1998;19:924–928.Google Scholar
10.Mitsuda, T, Arai, K, Fujita, S, Yokota, S. Demonstration of mother-to-infant transmission of Staphylococcus aureus by pulsed-field gel electrophoresis. Eur J Pediatr 1996;155:194–199.CrossRefGoogle ScholarPubMed
11.Hollis, RJ, Barr, JL, Doebbeling, BN, Pfaller, MA, Wenzel, RP. Familial carriage of methicillin-resistant Staphylococcus aureus and subsequent infection in a premature neonate. Clin Infect Dis 1995;21:328–332.CrossRefGoogle Scholar
12.Jones, CA. Maternal transmission of infectious pathogens in breast milk. J Paediatr Child Health 2001;37:576–582.CrossRefGoogle ScholarPubMed
13.Tenover, FC, Arbert, RD, Goering, RV, et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233–2239.CrossRefGoogle ScholarPubMed
14.Lemoine, L. Possible transmission of methicillin-resistant Staphylococcus aureus by expressed human breast milk. J Hosp Infect 1987;9:93–94.Google Scholar
15.Cooke, RPD, Devlin, J, Robinson, MJ. Breast milk and methicillin-resistant Staphylococcus aureus. J Hosp Infect 1987;10:312.CrossRefGoogle ScholarPubMed