EPIDEMIOLOGY OF ESCHERICHIA COLI K1 COLONIZATION IN NEWBORN INFANTS

Abstract

Previous clinical and laboratory studies have shown the E. coli (EC) capsular polysaccharide antigen K1 to be a virulence factor in neonatal meningitis. A prospective study of the factors influencing EC K1 colonization of neonates was undertaken. EC K1 colonies were identified on specific antibody-impregnated agar. The prevalence rate of K1 strains among 389 babies from 9 geographically distinct nurseries was 0 to 31% (mean 16%). Weekly surveillance of 93 healthy prematures during an 8 week period demonstrated EC K1 in 20 to 45% of rectal cultures. Similar K1 isolation rates from rectal cultures of term infants were observed and varied within the same nursery related to crowding conditions. Early acquisition of EC K1 was usually from maternal sources while delayed colonization (30% of neonates) was more likely from nosocomial sources. 11% of EC from 209 pregnant women with urinary tract infection contained K1 suggesting the genitourinary tract as a possible source of infant infection. 7 of 9 infants with EC K1 sepsis or meningitis had identical EC K1 recovered from maternal rectal cultures; with 1 infant an identical EC K1 was cultured from blood, gastric aspirate, placenta and infant and maternal rectal cultures.

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