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Guo D, Cao X, Li S, Ou Q, Lin D, Yao Z, Chen S, Wu C, Wen G, Ye X. Neonatal colonization of group B Streptococcus in China: Prevalence, antimicrobial resistance, serotypes, and molecular characterization. Am J Infect Control 2018; 46:e19-e24. [PMID: 29305279 DOI: 10.1016/j.ajic.2017.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/28/2017] [Accepted: 10/28/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Group B Streptococcus (GBS) remains a leading cause of neonatal mortality and morbidity. This study aimed to determine the prevalence, antimicrobial susceptibility, serotypes, and molecular characterization of GBS colonized in neonates. METHODS A cross-sectional study was conducted using a multistage sampling method. Swabs for GBS identification were taken from infants' ear, oral cavity, and umbilicus immediately after birth. All GBS isolates were tested for antimicrobial susceptibility, resistance genes, serotyping, multilocus sequence typing, and virulence genes. RESULTS Of the 1,814 neonates, 1.3% tested positive for GBS, with 66.7% tested as multidrug resistant. All GBS isolates were susceptible to penicillin, but rates of resistance to tetracycline and erythromycin were high (70.8%), with the predominant resistance genes being tetM and ermB. The predominant serotype was III, followed by Ia and Ib, and the most common genotypes were sequence type (ST) 19, ST10, and ST485. Notably, we found that ST19 and ST17 isolates were associated with serotype III, resistant to tetracycline, erythromycin, and clindamycin, and carrying ermB, tetM, and rib; ST10 and ST12 isolates were associated with serotype Ib, resistant to erythromycin and clindamycin, and carrying ermB and alphaC; and ST485 isolates were associated with serotype Ia and carrying mefA/E, tetM, and epsilon. CONCLUSIONS These findings indicate a high prevalence of multidrug-resistant GBS and specific phenotype-genotype combinations for GBS clones.
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Pinto AM, Pereira TA, Alves V, Araújo A, Lage OM. Incidence and serotype characterisation of Streptococcus agalactiae in a Portuguese hospital. J Clin Pathol 2017; 71:508-513. [PMID: 29180508 DOI: 10.1136/jclinpath-2017-204646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/16/2017] [Accepted: 11/03/2017] [Indexed: 11/04/2022]
Abstract
AIMS Streptococcus agalactiae, commonly known as group B Streptococcus (GBS), has been recognised as a worldwide causative pathogenic agent of neonatal sepsis, meningitis and pneumonia. To better understand the behaviour of S. agalactiae in pregnant women from a hospital from the North of Portugal, retrospective analyses were performed to describe epidemiological, clinical and microbiological characteristics of the isolates obtained. METHODS Based on laboratorial records and the hospital's patient files, a 6-year retrospective study was performed to analyse S. agalactiae isolates from screened pregnant women between 35 and 37 weeks of gestation and hospitalised neonates from pregnant women between 24 and 41 weeks of gestation admitted in Hospital Pedro Hispano. Serotype characterisation was also performed in 67 GBS strains. RESULTS In 6692 pregnant women between 35 and 37 weeks of gestation screened between 2011 and 2016, a total of 1377 S. agalactiae isolates (21%) were found. A high percentage (40%) of unknown colonisation status among hospitalised neonates from pregnant women between 24 and 41 weeks of gestations was also found. The incidence of neonatal sepsis was 8.7 (95% CI 7.0 to 10.8) cases per 1000 live births. Regarding serotype characterisation, serotype III (22.4%) was the most frequent, followed by serotype Ia (19.4%) and serotypes Ib and V (both with 17.9%). CONCLUSION High epidemiological values of GBS colonisation and incidence were found in this study. In Portugal studies on the epidemiology and behaviour of S. agalactiae remain limited, reinforcing the importance and need for S. agalactiae screening across the country.
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Affiliation(s)
- Ana Mafalda Pinto
- Department of Biology, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Tamegão Aires Pereira
- Department of Women, Children and Youth, Pediatrics and Neonatology Service, Hospital Pedro Hispano, Matosinhos, Porto, Portugal
| | - Valquíria Alves
- Department of MCDT, Clinical Pathology Service, Hospital Pedro Hispano, Matosinhos, Porto, Portugal
| | | | - Olga Maria Lage
- Department of Biology, Faculty of Sciences, University of Porto, Porto, Portugal.,CIMAR/CIIMAR - Interdisciplinary Centre for Marine and Environmental Research, University of Porto, Porto, Portugal
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Belard S, Toepfner N, Capan-Melser M, Mombo-Ngoma G, Zoleko-Manego R, Groger M, Matsiegui PB, Agnandji ST, Adegnika AA, González R, Kremsner PG, Menendez C, Ramharter M, Berner R. Streptococcus agalactiae Serotype Distribution and Antimicrobial Susceptibility in Pregnant Women in Gabon, Central Africa. Sci Rep 2015; 5:17281. [PMID: 26603208 PMCID: PMC4658565 DOI: 10.1038/srep17281] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 09/28/2015] [Indexed: 11/17/2022] Open
Abstract
Neonatal invasive disease due to Streptococcus agalactiae is life threatening and preventive strategies suitable for resource limited settings are urgently needed. Protective coverage of vaccine candidates based on capsular epitopes will relate to local epidemiology of S. agalactiae serotypes and successful management of critical infections depends on timely therapy with effective antibiotics. This is the first report on serotype distribution and antimicrobial susceptibility of S. agalactiae in pregnant women from a Central African region. Serotypes V, III, and Ib accounted for 88/109 (81%) serotypes and all isolates were susceptible to penicillin and clindamycin while 13% showed intermediate susceptibility to erythromycin.
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Affiliation(s)
- Sabine Belard
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.,Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nicole Toepfner
- Clinic and Polyclinic for Pediatrics and Adolescent Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mesküre Capan-Melser
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.,Département de Parasitologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Rella Zoleko-Manego
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.,Ngounie Medical Research Centre, Fougamou, Gabon
| | - Mirjam Groger
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Selidji T Agnandji
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Ayôla A Adegnika
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Raquel González
- ISGlobal, Barcelona Ctr. Int. Health Res (CRESIB), Hospital Clínic- Universitat de Barcelona), Barcelona, Spain
| | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Clara Menendez
- ISGlobal, Barcelona Ctr. Int. Health Res (CRESIB), Hospital Clínic- Universitat de Barcelona), Barcelona, Spain
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Reinhard Berner
- Clinic and Polyclinic for Pediatrics and Adolescent Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Bergal A, Loucif L, Benouareth DE, Bentorki AA, Abat C, Rolain JM. Molecular epidemiology and distribution of serotypes, genotypes, and antibiotic resistance genes of Streptococcus agalactiae clinical isolates from Guelma, Algeria and Marseille, France. Eur J Clin Microbiol Infect Dis 2015; 34:2339-48. [PMID: 26415872 DOI: 10.1007/s10096-015-2487-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 09/03/2015] [Indexed: 02/05/2023]
Abstract
This study describes, for the first time, the genetic and phenotypic diversity among 93 Streptococcus agalactiae (group B Streptococcus, GBS) isolates collected from Guelma, Algeria and Marseille, France. All strains were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The molecular support of antibiotic resistance and serotyping were investigated by polymerase chain reaction (PCR). The phylogenetic lineage of each GBS isolate was determined by multilocus sequence typing (MLST) and grouped into clonal complexes (CCs) using eBURST. The isolates represented 37 sequence types (STs), 16 of which were novel, grouped into five CCs, and belonging to seven serotypes. Serotype V was the most prevalent serotype in our collection (44.1%). GBS isolates of each serotype were distributed among multiple CCs, including cps III/CC19, cps V/CC1, cps Ia/CC23, cps II/CC10, and cps III/CC17. All isolates presented susceptibility to penicillin, whereas resistance to erythromycin was detected in 40% and tetracycline in 82.2% of isolates. Of the 37 erythromycin-resistant isolates, 75.7% showed the macrolide-lincosamide-streptogramin B (MLSB)-resistant phenotype and 24.3% exhibited the macrolide (M)-resistant phenotype. Constitutive MLSB resistance (46%) mediated by the ermB gene was significantly associated with the Guelma isolates, whereas the M resistance phenotype (24.3%) mediated by the mefA/E gene dominated among the Marseille isolates and belonged to ST-23. Tetracycline resistance was predominantly due to tetM, which was detected alone (95.1%) or associated with tetO (3.7%). These results provide epidemiological data in these regions that establish a basis for monitoring increased resistance to erythromycin and also provide insight into correlations among clones, serotypes, and resistance genes.
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Affiliation(s)
- A Bergal
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France.,Département d'Écologie et Génie de l'Environnement, Faculté des Sciences de la Nature et de la Vie et Sciences de la Terre et de l'Univers, Université 8 Mai 1945, Guelma, Algeria
| | - L Loucif
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France.,Laboratoire de Biotechnologie des Molécules Bioactives et de la Physiopathologie Cellulaire (LBMBPC), Université El Hadj Lakhdar, Batna, Algeria
| | - D E Benouareth
- Département d'Écologie et Génie de l'Environnement, Faculté des Sciences de la Nature et de la Vie et Sciences de la Terre et de l'Univers, Université 8 Mai 1945, Guelma, Algeria
| | - A A Bentorki
- Laboratoire de Microbiologie, CHU Dorban, Annaba, Algeria
| | - C Abat
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France
| | - J-M Rolain
- Facultés de Médecine et de Pharmacie, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63 CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Marseille, France.
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Quiroga M, Pegels E, Oviedo P, Pereyra E, Vergara M. Antibiotic susceptibility patterns and prevalence of group B Streptococcus isolated from pregnant women in Misiones, Argentina. Braz J Microbiol 2008; 39:245-50. [PMID: 24031210 PMCID: PMC3768385 DOI: 10.1590/s1517-83822008000200009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 11/22/2007] [Accepted: 05/05/2008] [Indexed: 11/22/2022] Open
Abstract
This study was performed to determine the susceptibility patterns and the colonization rate of Group B Streptococcus (GBS) in a population of pregnant women. From January 2004 to December 2006, vaginal-rectal swabs were obtained from 1105 women attending Dr. Ramón Madariaga Hospital, in Posadas, Misiones, Argentina. The carriage rate of GBS among pregnant women was 7.6%. A total of 62 GBS strains were randomly selected for in vitro susceptibility testing to penicillin G, ampicillin, tetracycline, levofloxacin, gatifloxacin, ciprofloxacin, quinupristin-dalfopristin, linezolid, vancomycin, rifampicin, trimethoprim- sulfametoxazol, nitrofurantoin, gentamicin, clindamycin and erythromycin, and determination of resistance phenotypes. No resistance to penicillin, ampicillin, quinupristin-dalfopristin, linezolid, and vancomycin was found. Of the isolates examined 96.8%, 98.3%, 46.8%, and 29.0% were susceptible to rifampicin, nitrofurantoin, trimethoprim-sulfametoxazol and tetracycline, respectively. Rank order of susceptibility for the quinolones was: gatifloxacin (98.4%) > levofloxacin (93.5%) > ciprofloxacin (64.5%). The rate of resistance to erythromycin (9.7%) was higher than that of other reports from Argentina. High-level resistance to gentamicin was not detected in any of the isolates. Based on our finding of 50% of GBS isolates with MIC to gentamicin equal o lower than 8 μg/ml, a concentration used in one of the selective media recommended for GBS isolation, we suggested, at least in our population, the use of nalidixic acid and colistin in selective media with the aim to improve the sensitivity of screening cultures for GBS carriage in women.
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Affiliation(s)
- M Quiroga
- Universidad Nacional de Misiones , Posadas, Misiones , Argentina
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Al-Sweih N, Hammoud M, Al-Shimmiri M, Jamal M, Neil L, Rotimi V. Serotype distribution and mother-to-baby transmission rate of Streptococcus agalactiae among expectant mothers in Kuwait. Arch Gynecol Obstet 2005; 272:131-5. [PMID: 15702324 DOI: 10.1007/s00404-004-0705-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Accepted: 10/12/2004] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a formidable pathogen that is commonly responsible for early-onset and late-onset infections with high morbidity and mortality in the neonatal period. Since this organism is usually acquired via the mother's birth canal during labor, this study investigated the maternal carriage rate, mother-to-baby transmission rate, and the common GBS serotypes found among expectant mothers and their babies in Kuwait. METHODS The setting was the Maternity Hospital, Kuwait. Low vaginal-anorectal swabs (LVRS) and urine specimens were collected from 847 pregnant women during labor. Ear and umbilical swabs from their new-born babies were also collected. Each specimen was cultured on selective Todd-Hewitt media. Isolates were identified and serotyped by established methods. RESULTS Of the 847 mothers, 124 (14.6%) were colonized and 74 (8.7%) babies were colonized, mainly at the umbilicus. The 124 GBS-positive mothers gave birth to 44 babies that were colonized by GBS at one or both sites, which corresponds to a mother-to-baby transmission rate of (35.5%). A total of 193 isolates were serotyped. The majority of the GBS isolates belonged to serotypes III (47; 24.3%), V (42; 21.8%), Ia (25; 12.9%), II and VI (15; 7.8%) each, and VII (11; 5.7%). Only 4 (2.1%) and 1 (0.5%) isolates belonged to serotypes Ib and IV respectively. No isolate belonged to serotype VIII and 33 (17.1%) were non-typable (NT).
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Affiliation(s)
- Noura Al-Sweih
- Department of Microbiology, Faculty of Medicine, Kuwait University, 24923, Al-Safat, 13110, Kuwait
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Lopardo HA, Vidal P, Jeric P, Centron D, Paganini H, Facklam RR, Elliott J. Six-month multicenter study on invasive infections due to group B streptococci in Argentina. J Clin Microbiol 2003; 41:4688-94. [PMID: 14532204 PMCID: PMC254350 DOI: 10.1128/jcm.41.10.4688-4694.2003] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Revised: 06/09/2003] [Accepted: 07/30/2003] [Indexed: 11/20/2022] Open
Abstract
There is little information about invasive infections by group B streptococci (GBS) and their antimicrobial susceptibilities in Latin America. We performed a prospective multicenter study to determine the serotype distribution and the antimicrobial susceptibility of GBS in Argentina. We identified 58 cases, but only 44 had sufficient data to be evaluated. Eight early-, four late-, and one fatal late, late-onset neonatal infections due to GBS were found. A total of 31 patients were adults with bacteremia, skin and soft tissue infections, osteomyelitis, arthritis, meningitis, abdominal infections, and renal abscess. Serotype III was prevalent in late-onset neonatal disease, and several serotypes (Ia/c, III, Ia, and II) were involved in early-onset neonatal infections. Serotypes II, Ia/c, III, and IV were commonly found in adults, with serotype II prevalent in younger adults (18 to 69 years old) and serotype Ia/c prevalent in elderly adults (>70 years old). The mortality rate attributable to GBS infections was 10.8%. All GBS were susceptible to penicillin and ceftriaxone. Resistance to clindamycin (1.7%), erythromycin (5.2%), azithromycin (5.2%), minocycline (69%), and tetracycline (72.4%), to high levels of kanamycin and amikacin (1.7%), and to intermediately high levels of gentamicin (1.7%) was observed. The bifunctional enzyme AAC6'-APH2" was detected in the isolate resistant to aminoglycosides, and other genetic determinants were identified in other resistant isolates: tetM and tetO in tetracycline-resistant streptococci and mefA and ermTR for efflux-mediated and inducible macrolide-lincosamide-streptogramin B-resistant streptococci, respectively. For clinical purposes and rapid and easy detection of high-level aminoglycoside-resistant GBS, a screening method that used 1,000- micro g kanamycin disks is proposed.
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Affiliation(s)
- Horacio A Lopardo
- Servicio de Microbiología, Hospital de Pediatría, Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.
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Amin A, Abdulrazzaq YM, Uduman S. Group B streptococcal serotype distribution of isolates from colonized pregnant women at the time of delivery in United Arab Emirates. J Infect 2002; 45:42-6. [PMID: 12217731 DOI: 10.1053/jinf.2001.0990] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the maternal colonization rate with group B streptococcus (GBS) and to identify the most frequent GBS serotypes occurring in UAE women during labour. STUDY DESIGN From February 1998 to January 1999, five hundred and sixty three pregnant women from a similar socio-economic and ethnic population were enrolled for the study. High vaginal swab cultures for GBS were obtained at the time of admission for delivery. Isolates were classified according to their capsular polysaccharide types (Ia, Ib, Ic, II-V) and c protein antigen compound. RESULTS Fifty-seven (10.1%) of 563 mothers were found to be carriers of GBS. Among the isolates, serotype IV (26.3%) predominated followed by type Ia (21.0%), type III (17.6%), type V (12.3%) and nontypeable, which accounted for 15.8%. CONCLUSIONS In view of the unknown status for GBS carrier rates in our community, this study suggests that about 10% of UAE women are colonized with group B streptococcus at delivery. The serotype distribution of the isolates in this population is different than those reported elsewhere with type IV predominating followed by type Ia and III.
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Affiliation(s)
- A Amin
- Department of Microbiology, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
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Hsueh PR, Teng LJ, Lee LN, Ho SW, Yang PC, Luh KT. High incidence of erythromycin resistance among clinical isolates of Streptococcus agalactiae in Taiwan. Antimicrob Agents Chemother 2001; 45:3205-8. [PMID: 11600380 PMCID: PMC90806 DOI: 10.1128/aac.45.11.3205-3208.2001] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The in vitro susceptibilities of 266 isolates of Streptococcus agalactiae determined by the agar dilution method showed that 6% of isolates were nonsusceptible to penicillin and 46% was resistant to erythromycin. Of the erythromycin-resistant isolates, 86.3% had the macrolide-lincosamide-streptogramin (MLS) resistance phenotype (constitutive MLS, 85.5%; inducible MLS, 0.8%) and 13.7% had the M phenotype.
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Affiliation(s)
- P R Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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