CONCLUSION
To date, upper vaginal culture is not routinely recommended even in high-risk pregnancies47,48; nevertheless, screening for high-risk pregnancies may be justified if there is evidence that treatment of ESBL-E vaginal colonization improves neonatal outcomes. Therefore, we suggest the need for further studies on screening and treatment of ESBL-E vaginal colonization to improve the perinatal outcomes against the increasing threat of ESBL-E colonization during pregnancy. In conclusion, our findings indicate that judicious use of antibiotics and prudent cerclage are needed.