Abstract
Antibiotics are used for both group B streptococcal (GBS) prevention and treatment. Active population-based surveillance for invasive GBS disease was conducted in four states during 1996–2003. Of 3813 case-isolates, 91.0% (3471) were serotyped, 77.1% (2937) had susceptibility testing, and 46.6% (3471) had both. All were sensitive to penicillin, ampicillin, cefazolin, cefotaxime, and vancomycin. Clindamycin and erythromycin resistance was 12.7% and 25.6%, respectively, and associated with serotype V (P < .001). Clindamycin resistance increased from 10.5% to 15.0% (X 2 for trend 12.70; P < .001); inducible clindamycin resistance was associated with the erm genotype. Erythromycin resistance increased from 15.8% to 32.8% (X 2 for trend 55.46; P < .001). While GBS remains susceptible to beta-lactams, resistance to alternative agents such as erythromycin and clindamycin is an increasing concern.
Highlights
Early-onset group B Streptococcal (GBS) infection, occurring in the first 7 days of life, is a leading cause of invasive bacterial infection among newborns and generally results from vertical transmission of GBS from colonized mothers to their infants
Invasive GBS isolate data regarding antimicrobial susceptibility, serotype, and epidemiologic data were collected from selected counties in four states (Georgia, Minnesota, New York, and Oregon); all participated in the Centers for Disease Control and Prevention’s (CDC) Active Bacterial Core surveillance (ABCs) system of the Emerging Infections Program network for 1996–2003
Of the 5 373 patients, 71% had isolates submitted to a public health laboratory and the antimicrobial susceptibility testing was performed on 77.1% (2 937)
Summary
Early-onset group B Streptococcal (GBS) infection, occurring in the first 7 days of life, is a leading cause of invasive bacterial infection among newborns and generally results from vertical transmission of GBS from colonized mothers to their infants. Neonatal infection is commonly characterized by bacteremia, pneumonia, and meningitis; mortality from early-onset disease is estimated at 5%. GBS disease among pregnant women manifests as urinary tract infections, bacteremia, chorioamnionitis, endometritis, or septic abortions [1]. Among non-pregnant adults, GBS disease typically occurs among older or immunocompromised persons. In the 1990s, the incidence of early-onset neonatal GBS disease declined dramatically after widespread implementation of intrapartum antibiotic prophylaxis (IAP). Revisions to IAP guidelines in 2002 included universal GBS screening of pregnant women with vaginal and rectal cultures at Infectious Diseases in Obstetrics and Gynecology
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