Epidemiology, Antimicrobial Resistance, and Virulence Determinants of Group B Streptococcus in an Australian Setting

Jones, Sandra C.; Newton, Peter O.; Payne, Matthew S.; Furfaro, Lucy

doi:10.3389/fmicb.2022.839079

Cited by 3 publications

(1 citation statement)

References 53 publications

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“…Furthermore, the proportion of resistant strains with the clindamycin-erythromycinlevofloxacin pattern was 62.7%, and clindamycin-erythromycintetracycline-levofloxacin-chloramphenicol-resistant strains were identified. An Australian study found 32% co-resistance of clindamycin and erythromycin in 100 S. agalactiae strains (Jones et al, 2022). In Iran, the multiple-resistance rate of S. agalactiae was approximately 22% (Motallebirad et al, 2021), while in Brazil, one S. agalactiae strain exhibited a multidrug resistance pattern (de Figueiredo et al, 2021a).…”

Section: Discussionmentioning

confidence: 99%

Molecular characteristics and antibiotic resistance mechanisms of clindamycin-resistant Streptococcus agalactiae isolates in China

Liu

Jiang

et al. 2023

Front. Microbiol.

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Streptococcus agalactiae (Group B Streptococcus, GBS) is a major cause of neonatal infections with high morbidity and mortality, and clindamycin is the main antibiotic used to treat GBS infections in patients allergic to penicillin. We aimed to analyse the antibiotic sensitivity, sequence types, serotypes, virulence factors, and antibiotic resistance mechanisms of clinically isolated clindamycin-resistant S. agalactiae and provide basic data for the treatment, prevention, and control of clinical infection of S. agalactiae. A total of 110 strains of clindamycin-resistant S. agalactiae were collected from two tertiary hospitals in Hebei, China. We performed antibiotic sensitivity tests for 11 antibiotics on these strains and whole-genome sequencing analysis. All the strains were susceptible to penicillin, ampicillin, linezolid, vancomycin, tigecycline, and quinupristin–dalfopristin. Resistance to erythromycin, levofloxacin, tetracycline, and chloramphenicol were also observed. Genome sequence analysis revealed that all strains belonged to 12 sequence types (STs) related to six cloning complexes (CCs), namely CC10, CC19, CC23, CC651, CC1, and CC17. Five serotypes were identified, including IA, IB, II, III, and V. The most prominent resistance genes were mreA (100%) and ermB (81.8%). Furthermore, cfb, cylE, pavA and the gene cluster related to the pili were 100% present in all strains, followed by lmb (95.5%) and srr1 (67.2%). This study found that clindamycin-resistant S. agalactiae showed polymorphisms in molecular types and serotypes. Furthermore, multiple virulence factor genes have been identified in their genomes.

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Section: Discussionmentioning

confidence: 99%

Molecular characteristics and antibiotic resistance mechanisms of clindamycin-resistant Streptococcus agalactiae isolates in China

Liu

Jiang

et al. 2023

Front. Microbiol.

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Beta‐lactam allergy risk stratification in a maternity population in Australia: Scope for allergy de‐labelling

Jeong,

Saleh,

Heap

et al. 2024

Aust NZ J Obst Gynaeco

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BackgroundUnconfirmed beta‐lactam allergy in pregnant people has been associated with higher morbidity, unnecessary exposure to broad‐spectrum antibiotics and prolonged hospitalisation. There are no published data on beta‐lactam allergies in pregnant people in Australia.AimsThe aim was to describe patient‐reported beta‐lactam allergies and appropriateness for antibiotic allergy de‐labelling in a maternity cohort in Australia.MethodsMaternity patients aged ≥18 years admitted to our institution between March 2021 and June 2021 with a beta‐lactam allergy documented in their electronic medical record were interviewed for details of their allergy. The documented allergies were compared to the allergy history obtained from the interview. Severity of the allergy was rated, and appropriateness for allergy de‐labelling was assessed using the Victorian Therapeutics Advisory Group beta‐lactam antibiotic allergy assessment tool.ResultsOne hundred and fifty‐three beta‐lactam allergies (182 reactions) were reported by 145 patients. Penicillin class antibiotics were the most frequently implicated, including unspecified penicillins (95/153, 62%), amoxicillin (19/153, 13%) and amoxicillin‐clavulanate (8/153, 5%). Allergy documentation required amending in 52 of 145 patients (36%); 85 of 153 (56%) of the beta‐lactam allergies were considered low risk and potentially appropriate for direct oral re‐challenge.ConclusionBeta‐lactam allergies were inaccurately documented in more than one third of the maternity patients included in our study. As such, education of maternity care providers about the importance of accurate allergy history taking remains an urgent unmet need. Furthermore, allergy assessment and de‐labelling during pregnancy should be considered in maternity patients to optimise antibiotic prescribing and to improve maternal and neonatal health outcomes.

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An Overview of Macrolide Resistance in Streptococci: Prevalence, Mobile Elements and Dynamics

et al. 2022

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Streptococcal infections are usually treated with beta-lactam antibiotics, but, in case of allergic patients or reduced antibiotic susceptibility, macrolides and fluoroquinolones are the main alternatives. This work focuses on studying macrolide resistance rates, genetic associated determinants and antibiotic consumption data in Spain, Europe and also on a global scale. Macrolide resistance (MR) determinants, such as ribosomal methylases (erm(B), erm(TR), erm(T)) or active antibiotic efflux pumps and ribosomal protectors (mef(A/E)-mrs(D)), are differently distributed worldwide and associated with different clonal lineages and mobile genetic elements. MR rates vary together depending on clonal dynamics and on antibiotic consumption applying selective pressure. Among Streptococcus, higher MR rates are found in the viridans group, Streptococcus pneumoniae and Streptococcus agalactiae, and lower MR rates are described in Streptococcus pyogenes. When considering different geographic areas, higher resistance rates are usually found in East-Asian countries and milder or lower in the US and Europe. Unfortunately, the availability of data varies also between countries; it is scarce in low- and middle- income countries from Africa and South America. Thus, surveillance studies of macrolide resistance rates and the resistance determinants involved should be promoted to complete global knowledge among macrolide resistance dynamics.

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Epidemiology, Antimicrobial Resistance, and Virulence Determinants of Group B Streptococcus in an Australian Setting

Cited by 3 publications

References 53 publications

Molecular characteristics and antibiotic resistance mechanisms of clindamycin-resistant Streptococcus agalactiae isolates in China

Molecular characteristics and antibiotic resistance mechanisms of clindamycin-resistant Streptococcus agalactiae isolates in China

Beta‐lactam allergy risk stratification in a maternity population in Australia: Scope for allergy de‐labelling

An Overview of Macrolide Resistance in Streptococci: Prevalence, Mobile Elements and Dynamics

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