Rodríguez-Morales AJ, Rodríguez CN, Garcia A, Pastran B, Jiménez I, Meijomil P

Language: English
References: 17
Page: 115-118
PDF size: 81.76 Kb.

ABSTRACT

Group B streptococci (GBS) are emerging as a cause of serious infection worldwide. The capsular polysaccharides are not only important virulence factors but also the target of vaccine development efforts. Increasing resistance of group B Streptococcus to clindamycin and erythromycin has been noted in many parts of the world. Objective: To describe resistance patterns of Streptococcus agalactiae isolated from clinical samples in a general hospital of Caracas, Venezuela. We evaluated Streptococcus agalactiae strains isolates collected from patients with suspected infections in a hospital of Caracas, Venezuela Venezuela (West General Hospital) between 1997–2003. For the studied period, 120 clinical strains were isolated. Methodology: Clinical samples were processed and identified with standard cultures and biochemical tests. In vitro antimicrobial susceptibility of the isolates was assessed by an agar disk diffusion method using Mueller-Hinton agar as recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Isolates were tested against 12 drugs, including: clindamycin, ciprofloxacin, erythromycin, chloramphenicol, penicillin, teicoplanin and vancomycin. Results: S. agalactiae showed 18.8% of resistance to clindamycin, 16.4% to ciprofloxacin, 9.8% to erythromycin. Intermediate resistance/susceptibility to clindamycin was observed in 11.8%, 46.3% against ciprofloxacin, 20.7% to erythromycin and 27.0% to chloramphenicol. Susceptibility was higher for penicillin (98.9%). No teicoplanin or vancomycin resistance was observed (100% susceptible). Discussion: Careful surveillance of S. agalactiae invasive infections in Venezuela is essential. In conclusion, GBS isolates from Caracas exhibit rates of macrolide and lincosamide resistance similar to those in other parts of the world but probably differ in the distribution of resistance phenotypes.

REFERENCES

1. Azavedo, J. C., M. McGavin, C. Duncan, D. E. Low, and A. McGeer. 2001. Prevalence and mechanisms of macrolide resistance in invasive and noninvasive group B streptococcus isolates from Ontario, Canada. Antimicrob. Agents Chemother. 45:3504–3508.

2. Bland, M. L., S. T. Vermillion, D. E. Soper, and M. Austin. 2001. Antibiotic resistance patterns of group B streptococci in late third-trimester rectovaginal cultures. Am. J. Obstet. Gynecol. 184:1125–1126.

3. De Mouy, D., J. D. Cavallo, R. Leclercq, R. Fabre, and AFORCORPI-BIO Network. 2001. Antibiotic susceptibility and mechanisms of erythromycin resistance in clinical isolates of Streptococcus agalactiae: French multicenter study. Antimicrob. Agents Chemother. 45:2400–2402.

4. Fernandez, M., M. E. Hickman, and C. J. Baker. 1998. Antimicrobial susceptibilities of group B streptococci isolated between 1992 and 1996 from patients with bacteremia or meningitis. Antimicrob. Agents Chemother. 42:1517–1519.

5. Werno, A.M., Anderson, T.P., and D. R. Murdoch. 2003. Antimicrobial susceptibilities of group B streptococci in New Zealand. Antimicrob. Agents Chemother. 47:2710–2711.

6. Hsueh, P. R., L. J. Teng, L. N. Lee, S. W. Ho, P. C. Yang, and K. T. Luh. 2001. High incidence of erythromycin resistance among clinical isolates of Streptococcus agalactiae in Taiwan. Antimicrob. Agents Chemother. 45:3205–3208.

7. Lin, F.-Y. C., P. H. Azimi, L. E. Weisman, J. B. Philips, J. Regan, P. Clark, G. G. Rhoads, J. Clemens, J. Troendle, E. Pratt, R. A. Brenner, and V. Gill. 2000. Antibiotic susceptibility profiles for group B streptococci isolated from neonates, 1995–1998. Clin. Infect. Dis. 31:76–79.

8. Morales, W. J., S. S. Dickey, P. Bornick, and D. V. Lim. 1999. Change in antibiotic resistance of group B streptococcus: impact on intrapartum management. Am. J. Obstet. Gynecol. 181:310–314.

9. Murdoch, D. R., and L. B. Reller. 2001. Antimicrobial susceptibilities of group B streptococci isolated from patients with invasive disease: 10-year perspective. Antimicrob. Agents Chemother. 45:3623–3624.

10. Pearlman, M. D., C. L. Pierson, and R. G. Faix. 1998. Frequent resistance of clinical group B streptococci isolates to clindamycin and erythromycin. Obstet. Gynecol. 92:258–261.

11. Rouse, D. J., W. W. Andrews, F.-Y. C. Lin, C. W. Mott, J. C. Ware, and J. B. Philips. 1998. Antibiotic susceptibility profile of group B Streptococcus acquired vertically. Obstet. Gynecol. 92:931–934.

12. Grimwood, K., P. R. Stone, I. A. Gosling, R. Green, B. A. Darlow, D. R. Lennon, and D. R. Martin. 2002. Late antenatal carriage of group B Streptococcus by New Zealand women. Aust. N. Z. J. Obstet. Gynecol. 42:182–186.

13. Stylianopoulos, A., N. Kelly, and S. Garland. 2002. Is penicillin and/or erythromycin resistance present in clinical isolates of group B Streptococcus in our community? Aust. N. Z. J. Obstet. Gynecol. 42:543–544.

14. Perez, J., Limansky, A., Toresani, I., Ebner, G., Di Bartolomeo, S., de Inocenti, I., Pretto, G., Salazar, N., Laferrara, M., Bottiglieri, M., Ballester, D., Morales, M., Rivera, L., Cacace, M.L., Castro, H., Roldan, L., Notario, R., Borda, N., Cera, G., Spoletti, M.J., Gregorini, E., and E. G. Sutich. 2004. Distribución de tipos capsulares y sensibilidad antimicrobiana de Streptococcus agalactiae causando infecciones en Argentina. Rev. Argent. Microbiol. 36:63-67.

15. Riera, L., Benavides, G., and N. Morillo. 1993. Colonización por Streptococcus grupo B en embarazadas y recién nacidos en una comunidad de Venezuela. Enferm. Infecc. Microbiol. Clin. 11:295-8.

16. National Committee for Clinical Laboratory Standards. 2002. Performance Standards for Antimicrobial Susceptibility Testing; approved standard, 8th ed. NCCLS document M2-A6 and M7A4. National Committee for Clinical Laboratory Standards, Wayne, Pa.

17. Leclercq, R. 2002. Mechanisms of resistance to macrolides and lincosamides: nature of the resistance elements and their clinical implications. Clin. Infect. Dis. 34:482–492.