Antimicrobial Susceptibilities of Group B Streptococcus Isolates from Prenatal Screening Samples

Abstract

Previous published reports have shown that group B Streptococcus (GBS) isolates were 100% susceptible to both penicillin (1, 2) and vancomycin (1); however, reduced susceptibilities to penicillin have been documented (3)(4)(5)(6)(7)(8). GBS susceptibilities to clindamycin and erythromycin have varied (2,(9)(10)(11)(12), and data regarding inducible clindamycin resistance are not always reported (2). We examined GBS susceptibilities to clindamycin, erythromycin, penicillin, and vancomycin from isolates obtained from prenatal screening samples.Vaginal/rectal ESwab (Copan Diagnostics Inc., Murrieta, CA) samples submitted for routine prenatal GBS screenings were evaluated. GBS was isolated and identified using Strep B Carrot Broth (Hardy Diagnostics, Santa Maria, CA) subcultured to GBS Detect (Hardy Diagnostics, Santa Maria, CA) as previously described (13). GBS Detect is a selective medium, and it allows for the isolation of GBS, including strains that are typically nonhemolytic on sheep blood agar. Immediately following isolation, GBS isolates were subcultured to sheep blood agar plates (Remel, Lenexa, KS) and incubated aerobically for 18 to 20 h at 35°C. Antimicrobial susceptibility testing (AST) was performed according to 2013 CLSI guidelines (14) on 102 GBS isolates using vancomycin and benzylpenicillin G (0.016 to 256 g/ml) Etest strips (bioMérieux, Durham, NC) and on 387 GBS isolates using clindamycin (2 g) and erythromycin (15 g) BBL Sensi-Discs (Becton, Dickinson, and Company, Sparks, MD) placed 12 mm apart to detect inducible clindamycin resistance.A total of 102/102 (100%) GBS isolates examined were susceptible to penicillin and vancomycin (Table 1). Both the MIC 50 and MIC 90 for penicillin were 0.064 g/ml, and both the MIC 50 and MIC 90 for vancomycin were 1.0 g/ml (data not shown). GBS isolates were susceptible to both clindamycin and erythromycin in 195/387 (50.4%) isolates and resistant to both clindamycin and erythromycin in 106/387 (27.4%) isolates (data not shown). An additional 8% (31/387) of isolates had a positive D-test, indicating inducible clindamycin resistance. The overall susceptibilities of GBS isolates to clindamycin were 62.8% (243/387) or 70.8% (274/ 387), accounting for or not accounting for inducible clindamycin resistance, respectively. The overall susceptibility of GBS isolates to erythromycin was 51.7% (200/387) ( Table 1).Current recommendations for GBS in pregnant women include AST of GBS strains isolated from penicillin-allergic women at high risk for anaphylaxis, screening for inducible clindamycin resistance when AST is performed, and reporting GBS isolates with inducible clindamycin resistance as clindamycin resistant (15). However, penicillin allergy may not always be known at the onset of labor. Our laboratory routinely performs clindamycin and erythromycin susceptibility testing on all GBS strains isolated from prenatal screening samples. Here we report rates of susceptibility of GBS to clindamycin, erythromycin, penicillin, and vancomycin that are very similar to those ...

Optimization of cord blood unit sterility testing: impact of dilution, analysis delay, and inhibitory substances

“…Ma and colleagues have demonstrated that S. epidermidis could have a high resistance profile to antibiotics, including penicillin . In contrast, studies have indicated that B. fragilis and S. agalactiae are very susceptible to penicillin . Except for K. pneumoniae , our results demonstrate a higher percentage of microbial detection in niCB compared with iCB, illustrating a bacterial susceptibility to inhibitory substances (Figs.…”

“…32 In contrast, studies have indicated that B. fragilis and S. agalactiae are very susceptible to penicillin. 33,34 Except for K. pneumoniae, our results demonstrate a higher percentage of microbial detection in niCB compared with iCB, illustrating a bacterial susceptibility to inhibitory substances ( Figs. 2 and 3).…”

Semina: Ciências Biológicas e da Saúde, Londrina, v. 39, n.1, jan./jun. 2018

“…In African countries, rates of erythromycin and clindamycin resistance ranging from 6.5% to 21.1% and 3.2% to 17.2%, respectively, were reported among GBS isolates from pregnant women. (11,28) Data from North America reported rates of resistance to erythromycin and clindamycin ranging from 27.4% to 36% and 27.4% to 33%, respectively. (11,29) High rates of GBS resistance for both antimicrobials were reported in Italy (32.2% for erythromycin and 43.8% for clindamycin) (30) and China (78.6% for erythromycin and 64.3% for clindamycin) (WANG et al, 2015).…”

“…(11,28) Data from North America reported rates of resistance to erythromycin and clindamycin ranging from 27.4% to 36% and 27.4% to 33%, respectively. (11,29) High rates of GBS resistance for both antimicrobials were reported in Italy (32.2% for erythromycin and 43.8% for clindamycin) (30) and China (78.6% for erythromycin and 64.3% for clindamycin) (WANG et al, 2015). (10) In contrast, lower rates of resistance were detected in Swiss (14.6% for erythromycin and 8.2% for clindamycin) (12) and Saudi Arabia (15.7% for erythromycin and 5.1% for clindamycin).…”

“…(7) The decrease in susceptibility to penicillin in GBS is rare, and 100% of penicillin-sensitive isolates were found in several regions of the world. (10)(11)(12)(13) However, GBS isolates with decreased susceptibility to penicillin were previously described. This phenomenon occurs due to the accumulation of mutations in the penicillinbinding proteins PBP1, PBP2b and PBP2x, which participate in cell wall biosynthesis.…”