What is the most common source of Escherichia coli infection in neonates?

The most common source of Escherichia coli infection in neonates is the maternal gastrointestinal tract. During childbirth, particularly if there are any ruptured membranes or prolonged labor, E. coli can be transmitted from the mother to the newborn. The bacteria are part of the normal flora in the intestines, and their presence in the vaginal flora can lead to an opportunistic infection in the neonate. This risk is particularly heightened if the mother has a urinary tract infection or other infection caused by E. coli around the time of delivery, as the bacteria can ascend and colonize the birth canal.

While hands of caregivers, contaminated equipment, and environmental exposure can also be sources of infection, they are less commonly implicated specifically in cases of neonatal E. coli infections compared to the maternal route. Maternal transmission highlights the importance of maternal health and hygiene during the peripartum period, as well as the potential need for monitoring and managing any existing infections in the mother.