Antibiotic susceptibility/resistant gene profiles of Group B streptococci isolates from pregnant wom
Authors:
ELIKWU Charles
Publication Type: Journal article
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Abstract
Background: Penicillin is recommended as the first‑line agent for intrapartum antibiotic
prophylaxis (IAP). Although Group B Streptococcus (GBS) strains are generally susceptible
to penicillin with only occasional resistance, they show varying resistance to erythromycin,
clindamycin, and tetracycline. Therefore, knowledge of the resistance profile of GBS in the
local environment will be useful for administration of appropriate intrapartum antibiotics
prophylaxis. Methodology: Rectovaginal swabs collected from pregnant women were cultured
for GBS using conventional media. Kirby–Bauer disc diffusion method was performed according
to the Clinical and Laboratory Standards Institute guidelines on GBS isolates to determine the
antibiotic susceptibility patterns of the isolates. Inducible clindamycin resistance was detected
by using the D‑zone test. Resistance determinants genes were discerned with conventional
polymerase chain reaction. Results: Carriage rates of GBS among pregnant women studied
were 19.7%. GBS colonizing the pregnant mothers were uniformly susceptible (100%) to
penicillin, vancomycin, and ceftriaxone. Only three (6.5%) of the isolates showed inducible
clindamycin resistance. ermA gene was present in all three GBS isolates with inducible
macrolide‑lincosamide‑streptogramin resistance. ermB was absent in all the strains tested.
mefA/E gene was carried by two of the macrolide‑clindamycin resistance isolates. tetM gene
was carried by all isolates with tetracycline resistance phenotypes. Conclusion: In this study,
all GBS isolates were susceptible to penicillin G, the recommended antibiotic for IAP. The
presence of resistance to erythromycin and inducible resistance to clindamycin excludes the
use of these agents as alternatives in cases of penicillin allergy. In this case, vancomycin is
the drug of choice as recommended in the updated Centers for Disease Control guideline.