Group B streptococcus in the Northern Territory in 2023: clindamycin down but not out

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Microbiology

Background:

• Group B Streptococcus (GBS) poses risks for newborns, with prophylactic antibiotics reducing neonatal infection.
• Penicillin is the primary treatment, but clindamycin is used for penicillin-allergic individuals.
• Increasing global clindamycin resistance in GBS is a growing concern.

Purpose of the Study:

• To assess current clindamycin resistance rates in GBS isolates in Australia's Northern Territory.
• To compare contemporary resistance data with historical Australian GBS resistance surveys.
• To inform clinical practice regarding GBS management in penicillin-allergic pregnant women.

Main Methods:

• Retrospective review of 113 GBS isolates from the Top End region of the Northern Territory in 2023.
• Analysis of clindamycin resistance prevalence within the studied GBS isolates.
• Comparison of findings with Australia-wide GBS resistance data from 2011.

Main Results:

• A substantial 30% clindamycin resistance rate was observed in GBS isolates in 2023.
• This represents a significant increase from the 4.2% rate reported in a 2011 Australia-wide survey.
• The findings highlight a concerning trend of escalating clindamycin resistance.

Conclusions:

• Current clindamycin resistance rates in GBS isolates in the Northern Territory are high.
• This trend necessitates urgent re-evaluation of GBS prophylactic strategies for penicillin-allergic pregnant women.
• Clinical practice guidelines may require updating to address rising clindamycin resistance in GBS.