|June 2007 · Vol. 19, No. 06
NEW DEVELOPMENTS THAT ARE CHANGING PATIENT CARE
How to respond to a CMV diagnosis in pregnancy; worries over methicillin-resistant S. aureus infection in and out of pregnancy; more on HPV vaccination
You must accurately confirm the diagnosis of a primary CMV infection—despite the unreliability of CMV serology
The prevalence of methicillin resistance in community-acquired S. aureus infections was 59%
Make it routine practice to culture an infected wound
Be alert for possible staph infection in pregnant women who test positive for group B strep at 35 to 37 weeks
HPV genotyping isn’t indicated in an infected woman who will be given the vaccine
Professor, Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Fla
Four studies caught my eye this past year. The first describes the use of systematic methodology to confirm the diagnosis of primary cytomegalovirus (CMV) infection in pregnancy and lower the rate of unnecessary pregnancy termination. Investigators were able to reclassify approximately 70% of women who had been diagnosed with CMV infection and reduce the number of pregnancy terminations by 73%.
Two other studies help define the emerging problem of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection, when to look for it, and how to treat it. In the first, researchers isolated S. aureus from the wounds of 320 patients with community-acquired infection and tested the samples for methicillin resistance, finding a prevalence of 59%. In the second study, investigators analyzed culture specimens from pregnant women for the presence of group B streptococci and S. aureus colonization. They found colonization with group B streptococci to be significantly associated with S. aureus colonization, with a prevalence odds ratio of 2.1.