Antimicrobial resistance in group B streptococcus: the Australian experience

Garland, Suzanne M., Cottrill, Erin, Markowski, Lisa, Pearce, Chris, Clifford, Vanessa, Ndisang, Daniel, Kelly, Nigel, Daley, Andrew J., Australasian Group for Antimicrobial Resistance–GBS Resistance Study Group and Faoagali, Joan (2011) Antimicrobial resistance in group B streptococcus: the Australian experience. Journal of Medical Microbiology, 60 2: 230-235. doi:10.1099/jmm.0.022616-0

Author Garland, Suzanne M.
Cottrill, Erin
Markowski, Lisa
Pearce, Chris
Clifford, Vanessa
Ndisang, Daniel
Kelly, Nigel
Daley, Andrew J.
Australasian Group for Antimicrobial Resistance–GBS Resistance Study Group
Faoagali, Joan
Title Antimicrobial resistance in group B streptococcus: the Australian experience
Journal name Journal of Medical Microbiology   Check publisher's open access policy
ISSN 0022-2615
Publication date 2011-02-01
Sub-type Article (original research)
DOI 10.1099/jmm.0.022616-0
Open Access Status Not yet assessed
Volume 60
Issue 2
Start page 230
End page 235
Total pages 6
Place of publication London, United Kingdom
Publisher The Microbiology Society
Language eng
Abstract Intrapartum chemoprophylaxis for pregnant group B streptococcus (GBS) carriers reduces vertical transmission, with a resultant decrease in neonatal as well as maternal morbidity from invasive GBS infection. Current Australian guidelines recommend penicillin for intrapartum prophylaxis of GBS carriers, with erythromycin or clindamycin for those with a β-lactam allergy. Recent reports globally suggest that resistance to erythromycin and clindamycin may be increasing; hence, a study was undertaken to promote an evidence base for local clinical guidelines. Samples collected for standardized susceptibility testing included 1160 invasive GBS isolates (264 isolates retrospectively from 1982 to 2001 and prospectively from 2002 to 2006, plus 896 prospectively collected colonizing GBS isolates gathered over a 12 month period from 2005 to 2006) from 16 laboratories around Australia. All isolates displaying phenotypic macrolide or lincosamide resistance were subsequently genotyped. No isolates showed reduced susceptibility to penicillin or vancomycin. Of the invasive isolates, 6.4% demonstrated phenotypic erythromycin resistance and 4.2% were clindamycin resistant. Of the erythromycin-resistant isolates, 53% showed cross-resistance to clindamycin. Very similar results were found in colonizing specimens. There was no statistically significant change in macrolide-resistance rates over the two study periods 1982-2001 and 2002-2006. Genotyping for macrolide and lincosamide-resistant isolates was largely consistent with phenotype. These findings suggest that penicillin therapy remains an appropriate first-line antibiotic choice for intrapartum GBS chemoprophylaxis, with erythromycin and/or clindamycin resistance being low in the Australian population. It would, nevertheless, be appropriate for laboratories screening for GBS in obstetric patients to consider macrolide sensitivity testing, particularly for those with β-lactam allergy, to ensure appropriate chemoprophylaxis.
Keyword MLSB
Group B streptococcus
Antibiotic expert group
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 17 times in Thomson Reuters Web of Science Article | Citations
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