Antibiotic Resistance Patterns in Invasive Group B Streptococcal Isolates

Castor, Mei L.; Whitney, Cynthia G.; Como‐Sabetti, Kathryn; Facklam, Richard R.; Ferrieri, Patricia; Bartkus, Joanne M.; Juni, Billie A.; Cieslak, Paul R.; Farley, Monica M.; Dumas, Nellie B.; Schrag, Stephanie J.; Lynfield, Ruth

doi:10.1155/2008/727505

Cited by 113 publications

(84 citation statements)

References 13 publications

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“…In Belgium, as determined by the National Reference Centre for GBS, macrolide resistance increased from 10.4% in the early 2000s to 33% among invasive strains isolated from 2008 to 2011 [59]. These figures are consistent with similar reports from Europe [61][62][63][64][65], North America [60,[66][67][68][69][70], and Asia [71,72], except some surveillance studies in Sweden reported 510% [73], thus showing some geographical differences. Different mechanisms account for the acquired resistance to macrolides in streptococci [74].…”

Section: Gbs Clinically Relevant Antimicrobial Susceptibility Profilesupporting

confidence: 76%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

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Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

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Section: Gbs Clinically Relevant Antimicrobial Susceptibility Profilesupporting

confidence: 76%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

View full text Add to dashboard Cite

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“…As serotype V GBS isolates have become the predominant GBS serotype causing invasive infections in adult patients and neonates in the USA and Canada (Castor et al, 2008;Dogan et al, 2005), Australia and New Zealand (Zhao et al, 2008), the predominance of serotype V among Kuwaiti women may be considered an emerging public health concern. Curiously, our results differed from those reported for pregnant women in neighbouring countries such as the United Arab Emirates, where serotype IV (26.3 %) was the most common serotype among GBS isolates (Amin et al, 2002), or Iran, where serotype III (41.8 %) was the most common serotype (Mansouri et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

Boswihi

Udo

Al‐Sweih

2012

Journal of Medical Microbiology

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A total of 143 group B streptococcus (GBS) isolates collected from mothers at the Maternity Hospital in Kuwait were investigated for their serotypes and antibiotic resistance, and screened by PCR for the carriage of genes for resistance to tetracycline (tetk, tetM, tetL, tetO), erythromycin (ermA, ermB, ermC, ermTR, ermM, mefA, mefE, msrA) and aminoglycosides (aph3, ant4, ant6). All isolates were serotyped using a latex agglutination test. Most of the isolates belonged to serotypes V (38.5 %), III (20.9 %), Ia (7.7 %) and II (11.2 %). Sixteen isolates (11.2 %) were nontypable. All isolates were susceptible to penicillin, ampicillin and cefotaxime (MICs 0.016-0.094 mg ml "1 ) but were resistant to trimethoprim (92.3 %), tetracycline (89.5 %), minocycline (89.5 %), high-level kanamycin (76.9 %), chloramphenicol (30.0 %), erythromycin (12.6 %), clindamycin (7.0 %), high-level streptomycin (3.5 %) and ciprofloxacin (0.7 %). The tetracycline-resistant isolates contained tetM (94.5 %), tetO (3.9 %), tetL (1.6 %) and tetK (0.8 %). The erythromycin-resistant isolates contained ermB (61.1 %), ermTR (38.9 %), ermA (5.5 %), mefA (5.5 %) and mefE (11 %). All high-level kanamycin-resistant isolates contained aph3. One of the high-level streptomycin-resistant isolates contained ant6. Partial DNA sequencing of aph3 revealed sequences with 99 % similarity to aph3 found in Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis, suggesting that the GBS isolates could have acquired aph3 from other Gram-positive cocci. The high proportion of isolates with resistance to tetracycline, high-level kanamycin and trimethoprim, and the increase in the prevalence of erythromycin resistance, represents an emerging public health concern that needs further surveillance. INTRODUCTIONGroup B streptococcus (GBS), also known as Streptococcus agalactiae, is a leading cause of serious infections in neonates and immunocompromised adults (Truog et al., 1976;Baker, 1979;High et al., 2005).GBS are encapsulated and have been classified into ten serotypes (Ia, Ib, II, III, IV, V, VI, VII, VIII and IX) on the basis of the capsular polysaccharide components of their cell wall (Victor & Rubens, 2000;Slotved et al., 2007). The capsular polysaccharide, as a virulence factor, assists GBS survival in vivo by avoiding recognition by the host defence system (Rubens et al., 1987). There are major differences between countries in the distribution of GBS serotypes. In the USA, Germany and Sweden, the most common serotypes isolated from infants and colonized mothers have been types Ia, III, and V (Persson et al., 2004;Brimil et al., 2006;Harrison et al., 1998). Serotype V strains emerged in the 1990s as a frequent cause of neonatal sepsis and adult diseases in the USA. On the other hand, serotypes VI and VIII represented 35.6 % and 24.7 %, respectively, of GBS isolated from pregnant women in Japan (Lachenauer et al., 1999).Penicillin G is the drug of choice for the intrapartum prophylaxis of GBS infections (Figueira-Coelho e...

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“…Epidemiological study of GBS serotypes is important because the GBS serotype is associated with pathogenicity (10,12,14) and antibiotic susceptibility (10)(11)(12)22). In addition, the development and formulation of current multivalent GBS vaccines depends on accurate population data of the serotype distribution (20).…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, alternative antibiotics are administrated for pregnant women with penicillin allergy, such as clindamycin, erythromycin, cefazolin, or vancomycin. In several countries, both clindamycin and erythromycin resistance has been reported in GBS isolates (10)(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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Characterization of Group B Streptococcus Isolated from Women in Saitama City, Japan

et al. 2012

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SUMMARY: Streptococcus agalactiae (group B streptococcus; GBS) is a common cause of neonatal sepsis and meningitis. Intrapartum antibiotic prophylaxis is effective in reducing neonatal GBS disease. Penicillin is recommended for intrapartum antibiotic prophylaxis; however, other antibiotics are administered to pregnant women with penicillin allergy. Serotyping and antibiotic susceptibility testing were performed on 376 GBS isolates collected from vaginal swabs in Saitama City. Of the 376 isolates, 328 (87.2z) were obtained from obstetrics and gynecology clinics. Although approximately 80z of the isolates (299/376) were from women of reproductive age (age, 15-49 years), no definite information on their pregnancy status was obtained. The most frequent serotype was V (19.1z) followed by Ib (18.6z), III (16.2z), VI (14.9z), and Ia (14.6z). None of the isolates were resistant to penicillins and cephalosporins. Isolates that were resistant to erythromycin (12.8z), clindamycin (9.0z), ofloxacin (19.4z), levofloxacin (18.4z), and tetracycline (46.5z) were detected. There was a high prevalence of resistance to erythromycin (39.3z) and clindamycin (27.9z) in serotype III. In addition, almost all serotype Ib isolates were resistant to ofloxacin and levofloxacin (both, 91.4z). Pulsed-field gel electrophoresis analysis on certain GBS isolates (serotype Ib, III, and V) indicated that there was genetic diversity among the resistant isolates obtained from a limited area of Japan. In conclusion, present intrapartum antibiotic prophylaxis with penicillins would be effective in Japan; however, performing susceptibility testing before administering other antibiotics is important in order to ensure activity against the relevant isolate.

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Antibiotic Resistance Patterns in Invasive Group B Streptococcal Isolates

Cited by 113 publications

References 13 publications

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

Characterization of Group B Streptococcus Isolated from Women in Saitama City, Japan

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