Research Progress on perinatal E. coli infection

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Infectious Diseases

Background:

• Intrapartum prophylaxis for group B streptococcus has shifted focus to E. coli as a leading cause of early-onset neonatal sepsis (EOS) and meningitis.
• Maternal vaginal colonization with virulent E. coli, affecting 20-30% of pregnant women, is linked to preterm birth, chorioamnionitis, and neonatal infections.
• Colonizing E. coli strains often possess virulence factors characteristic of extraintestinal pathogenic E. coli (ExPEC), similar to uropathogenic and neonatal meningitis-associated strains.

Purpose of the Study:

• To review current knowledge on perinatal E. coli infections.
• To focus on maternal colonization, vertical transmission, pathogenic mechanisms, and clinical aspects.
• To examine antimicrobial resistance trends and explore novel preventive strategies.

Main Methods:

• Literature review of current advances in perinatal E. coli infection.
• Synthesis of data on maternal colonization, transmission, virulence, and clinical outcomes.
• Analysis of antimicrobial resistance patterns, including ESBL-producing isolates.

Main Results:

• E. coli is a significant pathogen in neonatal sepsis and meningitis, with frequent vertical transmission from colonized mothers.
• Invasive E. coli infections can lead to severe outcomes, including mortality and long-term neurodevelopmental issues.
• The rise of multidrug-resistant strains, like ESBL-producers, presents challenges for prevention and empirical treatment.

Conclusions:

• Maternal E. coli colonization and vertical transmission are critical factors in neonatal infections.
• Understanding E. coli virulence and resistance is essential for developing effective perinatal strategies.
• Emerging preventive measures are needed to combat the increasing threat of E. coli in the perinatal period.