Change in antibiotic resistance of group B Streptococcus: Impact on intrapartum management

• Published in: American journal of obstetrics and gynecology 1999-08, Vol.181 (2), p.310-314
• Main Authors: Morales, Walter J., Dickey, Sonja S., Bornick, Patricia, Lim, Daniel V.
• Format: Article
• Language: English
• Subjects: Ampicillin - pharmacology; antibiotic resistance; Centers for Disease Control and Prevention protocol; Clindamycin - pharmacology; Drug Resistance, Microbial; Erythromycin - pharmacology; Female; Group B Streptococcus; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Penicillins - pharmacology; Pregnancy; Rectum - microbiology; Sepsis - microbiology; Sepsis - prevention & control; Streptococcal Infections - prevention & control; Streptococcal Infections - transmission; Streptococcus agalactiae - drug effects; Streptococcus agalactiae - isolation & purification; Vagina - microbiology
• ISSN: 0002-9378
• DOI: 10.1016/S0002-9378(99)70553-3

Objective: Intrapartum chemoprophylaxis has resulted in a significant reduction of group B Streptococcus neonatal infection. For penicillin-allergic patients, clindamycin or erythromycin is the recommended antibiotic. The purpose of this study was to establish any pattern of antibiotic resistance of group B streptococcal clinical isolates over the past 15 years. Study Design: Group B streptococcal isolates obtained from the lower genital tract were tested for sensitivity to ampicillin, penicillin, clindamycin, and erythromycin. The sensitivity of 100 group B streptococcal isolates retrieved in the period 1997-1998 was compared with that of 85 group B streptococcal isolates from 1980-1993. Results: From 1980-1993 group B streptococcal isolates were available for testing for antibiotic resistance along with 100 isolates from a second study period 1997-1998. Of the 100 group B streptococcal isolates from 1997-1998, 18 were resistant to erythromycin, of which 5 were also resistant to clindamycin, as compared with 1 of the 85 isolates from 1980-1993 that was resistant to erythromycin ( P < .001). All the isolates were sensitive to ampicillin and penicillin. All 18 resistant strains from 1997-1998 were found to be sensitive to cephalothin. Conclusion: Over the past 18 years there has been increased in vitro resistance of group B streptococci to both clindamycin and erythromycin. If other studies confirm these findings, modifications to the current Centers for Disease Control and Prevention recommendations may be necessary. (Am J Obstet Gynecol 1999;181:310-4.)