Which organism is NOT among the four specifically listed in the NASPHV compendium as shedding during birthing?

• A. Coxiella burnetii
• B. Brucella spp.
• C. Leptospira spp.
• D. Escherichia coli

Answer: (D)

Think about which pathogens are classically shed in birthing materials and can pose a risk to people handling those materials. Coxiella burnetii, Brucella spp., and Leptospira spp. are well known for being shed in placental tissues, fetal membranes, or birth fluids, which is why they’re singled out in the NASPHV compendium as birth-shedding organisms. Escherichia coli, while a common neonatal pathogen and a concern in many settings, is not listed for birth-fluid shedding in that compendium. Its transmission is usually linked to fecal contamination rather than peripartum shedding, so it’s not included in that particular list. In practice, this means maintaining appropriate PPE and careful handling of birth materials to guard against the perinatal agents specifically identified.