Emergence of nosocomial Pseudomonas aeruginosa colonization/infection in pregnant women with preterm premature rupture of membranes and in their neonates

The epidemiology, risk factors, maternal and neonatal outcomes of nosocomial Pseudomonas aeruginosa acquisition in preterm premature rupture of membranes were analysed. Of 63 women receiving antibiotic prophylaxis with coamoxiclav, 11 acquired P. aeruginosa vaginal carriage with a median delay of 15 days (6-42) i.e. an incidence of 8.94 per 1000 days of expectant management. Five neonates born to 11 positive mothers were colonized or infected, three of whom died of fulminant sepsis. The duration of antibiotic treatment and multipte pregnancy were identified as independent risk factors. The epidemiological. investigation revealed a vertical transmission between mothers and neonates, and suggested selective pressure of antibiotic treatment. (C) 2003 The Hospital Infection Society. Published by Elsevier Science Ltd. All rights reserved.