In Ae Yoon1, Dae Sun Jo2, Eun Young Cho3, Eun Hwa Choi4, Hoan Jong Lee4, Hyunju Lee5. 1. Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea; Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 463-707, Korea. 2. Department of Pediatrics, Chonbuk National University Children's Hospital, Chonbuk National University Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea. 3. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea. 4. Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea. 5. Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 463-707, Korea. Electronic address: mdopd@hanmail.net.
Abstract
BACKGROUND: Group B Streptococcus (GBS) strains are classified by the polysaccharide capsule, which is an important virulence factor and stimulator of antibody-associated immunity. As GBS infections in neonates may be life-threatening, GBS screening and intrapartum antibiotic prophylaxis have been implemented for prevention. In Korea, there are few reports on the GBS serotype distribution and antibiotic resistance patterns because GBS screening and intrapartum prophylaxis are not done routinely. METHODS: The serotype distribution and antibiotic resistance of GBS in infants in Korea with invasive bacterial infections were examined for the 19-year period 1995-2013. Isolates obtained previously from hospitals located in three different regions were analyzed for capsular serotype by PCR and sequencing and for antimicrobial susceptibility. RESULTS: Among 56 isolates serotyped, the most common serotypes were III (44.6%) and V (28.6%), followed by Ia (14.3%), Ib (10.7%), and VI (1.8%). No penicillin-resistant strains were detected, however 51.8% of the strains had resistance to erythromycin and 55.4% showed clindamycin resistance. Resistance was highest (93.8%) to both erythromycin and clindamycin for serotype V; all 15 isolates resistant to erythromycin were cMLSB phenotype and had a high level of resistance to both erythromycin and clindamycin with MIC levels >256μg/ml, and all but one were positive for ermB. CONCLUSION: In this study in Korea, serotype V was identified in a relatively large proportion of GBS isolates and this serotype showed a high level of resistance to erythromycin and clindamycin in a statistically significant majority. Continuous monitoring of changes in clinical disease and molecular characteristics is important for the treatment and prevention of invasive GBS disease in infants.
BACKGROUND:Group B Streptococcus (GBS) strains are classified by the polysaccharide capsule, which is an important virulence factor and stimulator of antibody-associated immunity. As GBS infections in neonates may be life-threatening, GBS screening and intrapartum antibiotic prophylaxis have been implemented for prevention. In Korea, there are few reports on the GBS serotype distribution and antibiotic resistance patterns because GBS screening and intrapartum prophylaxis are not done routinely. METHODS: The serotype distribution and antibiotic resistance of GBS in infants in Korea with invasive bacterial infections were examined for the 19-year period 1995-2013. Isolates obtained previously from hospitals located in three different regions were analyzed for capsular serotype by PCR and sequencing and for antimicrobial susceptibility. RESULTS: Among 56 isolates serotyped, the most common serotypes were III (44.6%) and V (28.6%), followed by Ia (14.3%), Ib (10.7%), and VI (1.8%). No penicillin-resistant strains were detected, however 51.8% of the strains had resistance to erythromycin and 55.4% showed clindamycin resistance. Resistance was highest (93.8%) to both erythromycin and clindamycin for serotype V; all 15 isolates resistant to erythromycin were cMLSB phenotype and had a high level of resistance to both erythromycin and clindamycin with MIC levels >256μg/ml, and all but one were positive for ermB. CONCLUSION: In this study in Korea, serotype V was identified in a relatively large proportion of GBS isolates and this serotype showed a high level of resistance to erythromycin and clindamycin in a statistically significant majority. Continuous monitoring of changes in clinical disease and molecular characteristics is important for the treatment and prevention of invasive GBS disease in infants.
Authors: Lola Madrid; Anna C Seale; Maya Kohli-Lynch; Karen M Edmond; Joy E Lawn; Paul T Heath; Shabir A Madhi; Carol J Baker; Linda Bartlett; Clare Cutland; Michael G Gravett; Margaret Ip; Kirsty Le Doare; Craig E Rubens; Samir K Saha; Ajoke Sobanjo-Ter Meulen; Johan Vekemans; Stephanie Schrag Journal: Clin Infect Dis Date: 2017-11-06 Impact factor: 20.999
Authors: Menagah Ezhumalai; AbdulRahman Muthanna; Zarizal Suhaili; Nurul Diana Dzaraly; Syafinaz Amin-Nordin; Mohammad Noor Azmai Amal; Mohd Nasir Mohd Desa Journal: Malays J Med Sci Date: 2020-02-27