Antimicrobial susceptibility and serotype distribution of Streptococcus agalactiae recto-vaginal colonizing isolates from pregnant women at a tertiary hospital in Pretoria, South Africa: an observational descriptive study letter

Abstract

IntroductionStreptococcus agalactiae or Group B Streptococcus (GBS) is a significant cause of neonatal sepsis. Intrapartum antibiotic prophylaxis is recommended for pregnant women identified to be recto-vaginally colonised between 34-37 weeks gestational age to decrease the risk of invasive disease in their newborns. The aim of this study was to investigate serotype distribution and antimicrobial susceptibility patterns of GBS isolates cultured from recto-vaginal specimens during pregnancy. MethodsSixty-nine archived maternal colonizing isolates were tested against penicillin, erythromycin, clindamycin, vancomycin and levofloxacin. Minimum Inhibitory Concentration (MIC) testing was performed using the E-test method. Serotyping was performed by latex agglutination method. ResultsThe most common serotypes detected were Ia (54%), III (20%), V (16%), II (6%), IV (2%) and Ib (1%), respectively. All isolates were fully susceptible to penicillin, vancomycin and levofloxacin. Eight (11%) and 50 (56%) isolates showed intermediate resistance to erythromycin and clindamycin respectively, and one isolate was resistant to erythromycin. MLSB phenomenon was noted in 3 (4%) of the isolates. ConclusionGBS colonizing isolates remain susceptible to penicillin and remains the drug of choice for intrapartum antibiotic prophylaxis and treatment of invasive disease in newbrons. Macrolides should only be used if clinically indicated due to the high prevalence of intermediate resistance. A hexavalent GBS vaccine currently under development would provide coverage for 100% of the isolates identified in this study.