The possibility of Escherichia coli transmission from pregnant women to the neonates.

Objective: To assess the homology of Escherichia coli between pregnant women and neonates and to identify the vertical transmission risk factors.

Study design: Pregnant women in 35-37 gestational weeks who underwent prenatal checkups between May 1st, 2015, and April 30th, 2016 were screened for Escherichia coli. Paired swabs from pregnant women and neonates were collected to evaluate the vertical transmission rate. Drug resistance, Multi-locus Sequence Typing, and potential risk factors were acquired to evaluate the homology and risk factors. Multiple logistic regression was used to account for potential confounders and evaluate the predictive ability of variables.

Results: There were 201 (42.5%) positive swabs from pregnant women and 27 (5.7%) from neonates. Escherichia coli vertical transmission rate was 22 (11.0%, 95% CI 6.7%-15.3%). The most common ST was ST1193. Age of pregnant women (OR 1.19, 95% CI 1.06-1.34), time of premature rupture of membranes (OR 1.09, 95% CI 1.01-1.18), time of prenatal antibiotics use (OR 0.87 95% CI 0.74-0.98), and drug-resistant categories (OR 1.42 95% CI 1.00-2.07) were identified as significant factors. The predictive model achieved an area under the curve of 0.795 (95% CI: 0.683-0.908) and 0.743 (95% CI: 0.628-0.859) for the model of 10 factors and 4 factors, respectively. Escherichia coli positivity increases the likelihood of neonate hospitalization.

Conclusion: The strong homology of Escherichia coli between pregnant women and neonates indicates the potential transmission of pathogenic strains, which should be screened and managed.