Point Mutation in the Group B Streptococcal
            <i>pbp2x</i>
            Gene Conferring Decreased Susceptibility to β-Lactam Antibiotics

Dahesh, Samira; Hensler, Mary E.; Sorge, Nina M. van; Gertz, Robert E.; Schrag, Stephanie J.; Nizet, Victor; Beall, Bernard

doi:10.1128/aac.00461-08

Cited by 196 publications

(125 citation statements)

References 13 publications

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Section: B-lactammentioning

confidence: 87%

“…However, in view of recent reports of reduced susceptibility to penicillin in some GBS isolates (Chu et al, 2007;Dahesh et al, 2008;Kimura et al, 2008;Nagano et al, 2008), these data suggest that further regular surveillance studies should be carried out on b-lactam susceptibility in GBS isolates.…”

Section: B-lactammentioning

confidence: 87%

“…of strains (and % of total) for which the MIC value (mg ml "1 ) was: Although the isolates were susceptible to the b-lactam antibiotics tested, the MICs of penicillin, ampicillin and cefotaxime for the majority of them were in the range 0.047-0.094 mg ml -1 , similar to the results of a previous study on GBS isolated in the same hospital in 2003 (AlSweih et al, 2005b). However, in view of recent reports of reduced susceptibility to penicillin in some GBS isolates (Chu et al, 2007;Dahesh et al, 2008;Kimura et al, 2008;Nagano et al, 2008), these data suggest that further regular surveillance studies should be carried out on b-lactam susceptibility in GBS isolates.In contrast to the resulsts for b-lactams, the 12.6 % erythromycin-resistance rate in the present study represents a significant increase (P,0.001) in the proportion of erythromycin-resistant isolates from the 0.7 % prevalence reported in GBS isolates obtained from patients in the same hospital in 2003 (Al-Sweih et al, 2005b). This increase may be related to the increased use of macrolides in the hospital.…”

mentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

“…As GBS isolates remain uniformly susceptible to penicillin, its prophylactic use has been instrumental in significantly reducing the incidence of early-onset diseases in neonates (Pylipow et al, 1994). However, GBS isolates with reduced susceptibility to penicillin have recently been reported (Chu et al, 2007;Dahesh et al, 2008;Kimura et al, 2008;Nagano et al, 2008).Erythromycin and clindamycin are used as alternative treatments for patients who are allergic to penicillin. However, erythromycin and clindamycin resistance have emerged in several countries (Aracil et al, 2002;Betriu et al, 2003;de Azavedo et al, 2001;De Mouy et al, 2001).…”

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confidence: 99%

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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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Section: B-lactammentioning

confidence: 87%

Section: B-lactammentioning

confidence: 87%

mentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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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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Epidemiology of Invasive Early-Onset and Late-Onset Group B Streptococcal Disease in the United States, 2006 to 2015

et al. 2019

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IMPORTANCE Invasive disease owing to group B Streptococcus (GBS) remains an important cause of illness and death among infants younger than 90 days in the United States, despite declines in early-onset disease (EOD; with onset at 0-6 days of life) that are attributed to intrapartum antibiotic prophylaxis (IAP). Maternal vaccines to prevent infant GBS disease are currently under development. OBJECTIVE To describe incidence rates, case characteristics, antimicrobial resistance, and serotype distribution of EOD and late-onset disease (LOD; with onset at 7-89 days of life) in the United States from 2006 to 2015 to inform IAP guidelines and vaccine development. DESIGN, SETTING, AND PARTICIPANTS This study used active population-based and laboratory-based surveillance for invasive GBS disease conducted through Active Bacterial Core surveillance in selected counties of 10 states across the United States. Residents of Active Bacterial Core surveillance areas who were younger than 90 days and had invasive GBS disease in 2006 to 2015 were included. Data were analyzed from December 2017 to April 2018. EXPOSURES Group B Streptococcus isolated from a normally sterile site. MAIN OUTCOMES AND MEASURES Early-onset disease and LOD incidence rates and associated GBS serotypes and antimicrobial resistance. RESULTS The Active Bacterial Core surveillance program identified 1277 cases of EOD and 1387 cases of LOD. From 2006 to 2015, EOD incidence declined significantly from 0.37 to 0.23 per 1000 live births (P < .001), and LOD rates remained stable (mean, 0.31 per 1000 live births). Among the mothers of 1277 infants with EOD, 617 (48.3%) had no indications for IAP and did not receive it, and 278 (21.8%) failed to receive IAP despite having indications. Serotype data were available for 1743 of 1897 patients (91.3%) from 7 sites that collect GBS isolates. Among patients with EOD, serotypes Ia (242 [27.3%]) and III (242 [27.3%]) were most common. Among patients with LOD, serotype III was most common (481 [56.2%]), and this increased from 2006 to 2015 from 0.12 to 0.20 cases per 1000 live births (P < .001). Serotype IV caused 53 cases (6.2%) of EOD and LOD combined. The 6 most common serotypes (Ia, Ib, II, III, IV, and V) caused 881 EOD cases (99.3%) and 853 LOD cases (99.7%). No β-lactam resistance was identified; 359 isolates (20.8%) tested showed constitutive clindamycin resistance. In 2015, an estimated 840 EOD cases and 1265 LOD cases occurred nationally. CONCLUSIONS AND RELEVANCE The rates of LOD among US infants are now higher than EOD rates. Combined with addressing IAP implementation gaps, an effective vaccine covering the most common serotypes might further reduce EOD rates and help prevent LOD, for which there is no current public health intervention.

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β‐Lactam Antibiotics

Testero

Fisher

Mobashery

2010

Burger's Medicinal Chemistry and Drug Discovery

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The β‐lactam classes of antibacterials are preeminent in the treatment of bacterial infection due to their unparalleled clinical efficacy and clinical safety. Following the discovery of the penicillins, successive β‐lactam drug discovery has added the cephalosporin, penem cephamycin, clavulanate, monobactam, nocardicin, and carbapenem subclasses. The driving force behind much of this era of discovery is the staggering ability of pathogenic bacteria to adapt previous generations of the β‐lactam by the acquisition and expression of resistance mechanisms. Although many factors contribute to β‐lactam resistance, alterations to the molecular targets of the β‐lactams (the penicillin binding proteins) and the use of enzymes (the β‐lactamases) capable of the hydrolytic deactivation of the β‐lactams are paramount. This review traces the historical development of β‐lactam drug discovery, with emphasis on the most recent progress in the medicinal chemistry, biochemistry, and microbiology of the β‐lactams leading to the discovery of new generation β‐lactam antibacterials effective against the Gram‐negative and ‐positive bacterial pathogens of current medical concern.

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Point Mutation in the Group B Streptococcal pbp2x Gene Conferring Decreased Susceptibility to β-Lactam Antibiotics

Cited by 196 publications

References 13 publications

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

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

Epidemiology of Invasive Early-Onset and Late-Onset Group B Streptococcal Disease in the United States, 2006 to 2015

β‐Lactam Antibiotics

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