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Antimicrobial susceptibility patterns of Streptococcus agalactiae in a German university hospital
Insights
Group B Streptococcus (GBS) antibiotic resistance is rising. Recent GBS strains show increased resistance to erythromycin and clindamycin, impacting neonatal infection treatment and prophylaxis strategies.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Group B streptococci (GBS) are a leading cause of neonatal sepsis and meningitis.
- Current treatment involves penicillin and gentamicin, with intrapartum prophylaxis using penicillin, ampicillin, or alternatives like erythromycin or clindamycin for allergic individuals.
Purpose of the Study:
- To investigate the antimicrobial susceptibility patterns of GBS strains.
- To identify trends in resistance, particularly to macrolides, in GBS isolates from neonates and adult women.
Main Methods:
- Analysis of 190 GBS strains from neonates (1993-1999) and 150 strains from adult women (1997, 1999).
- Susceptibility testing for penicillin, ampicillin, cefotaxime, erythromycin, and clindamycin.
Main Results:
- All GBS isolates remained susceptible to penicillin, ampicillin, and cefotaxime.
- Erythromycin resistance was 4.7% in neonatal isolates and 6% in adult isolates from 1997.
- By 1999, erythromycin resistance increased to 12% and clindamycin resistance to 7% in adult GBS isolates.
Conclusions:
- A concerning increase in macrolide resistance (erythromycin, clindamycin) among recent GBS strains is evident.
- This trend necessitates ongoing surveillance to monitor antimicrobial resistance patterns.
- Updated treatment and prophylaxis guidelines may be required to address emerging resistance.
Abstract:
Group B streptococci (GBS) are the major cause of neonatal sepsis and meningitis. GBS infection in neonates is usually treated with a combination of penicillin and gentamicin. According to consensus guidelines, pregnant women at risk receive intrapartum prophylaxis with either ampicillin or penicillin or, in case of allergy, with erythromycin or clindamycin. We investigated the susceptibility patterns of 190 GBS strains from neonates isolated from 1993-1999 and 150 GBS strains collected from adult women in 1997 and 1999. All isolates were susceptible to penicillin, ampicillin and cefotaxime. Erythromycin resistance among all isolates from neonates and from adult women in 1997 was 4.7% and 6%, respectively. In contrast, 12% of the isolates from adult women in 1999 were resistant to erythromycin and 7% were resistant to clindamycin. These findings show an increasing macrolide resistance in recent GBS strains and indicate the need for further surveillance.