@2024 Afarand., IRAN
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2019;3(2):53-57
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2019;3(2):53-57
Group B Streptococci and-Clindamycin Induced Phenotypic Resistance Pattern in Pregnant Women, Case Study of Sarem Women Hospital
ARTICLE INFO
Article Type
Original ResearchAuthors
Nomanpour B. (*1)Lashgari P. (1)
Hasani M. (1)
(*1) Department of Microbiology, Sarem Fertility & Infertility Research Center, Sarem Women’s Hospital, Tehran, Iran
Correspondence
Address: Sarem Women’s Hospital, End of Phase 3, Ekbatan Town, Tehran, IranPhone: +98 (21) 44674702
Fax: +98 (21) 44670432
nomanpoursh@gmail.com
Article History
Received: January 10, 2018Accepted: April 17, 2018
ePublished: June 15, 2019
ABSTRACT
Aims
Streptococcus agalactiae strains or group B streptococci (GBS) are the natural flora of the anogenital area of women and are the most important cause of death in the first week of infant birth. The aim of this study was to investigate the isolated strains of group B streptococci and phenotypic resistance pattern of clindamycin induced in pregnant women.
Materials & Methods This cross sectional descriptive study was done on the vaginal culture of 861 pregnant women. After a physical examination by a gynecologist, two vaginal swabs of vaginal discharges were taken in a 1ml sterile normal saline tube and two slides were delivered to the hospital laboratory for staining. The Specimens were cultured on Sheep blood agar, Eosin-methylene blue (EMB) agar and Sabouraud dextrose agar at 35±1Ċ and Chocolate agar were incubated in candle jar at the same temperature. After diagnostic tests, GBS was isolated and microbial susceptibility test was performed. Also, the Erythromycin-inducible resistances to clindamycin was measured by phenotypic D-test for the samples.
Findings Of the 861 samples sent to the laboratory, 141 cases (16.38%) were positive for GBS. The sensitivity of GBS isolates to penicillin, cefalexin, and ceftazidime was 98.58%, 97.8%, and 98.88%, respectively. There was no resistance to ampicillin and ceftriaxone in the samples, but 2.84% of them were resistant to ciprofloxacin. Clindamycin-induced resistance was positive in 14.89% of pregnant women.
Conclusion Among isolated bacteria, 16.38% of them are part of group B streptococci that 14.89% of them are clindamycin induced resistance and 38.6% of them have concurrent resistance to erythromycin and clindamycin.
Materials & Methods This cross sectional descriptive study was done on the vaginal culture of 861 pregnant women. After a physical examination by a gynecologist, two vaginal swabs of vaginal discharges were taken in a 1ml sterile normal saline tube and two slides were delivered to the hospital laboratory for staining. The Specimens were cultured on Sheep blood agar, Eosin-methylene blue (EMB) agar and Sabouraud dextrose agar at 35±1Ċ and Chocolate agar were incubated in candle jar at the same temperature. After diagnostic tests, GBS was isolated and microbial susceptibility test was performed. Also, the Erythromycin-inducible resistances to clindamycin was measured by phenotypic D-test for the samples.
Findings Of the 861 samples sent to the laboratory, 141 cases (16.38%) were positive for GBS. The sensitivity of GBS isolates to penicillin, cefalexin, and ceftazidime was 98.58%, 97.8%, and 98.88%, respectively. There was no resistance to ampicillin and ceftriaxone in the samples, but 2.84% of them were resistant to ciprofloxacin. Clindamycin-induced resistance was positive in 14.89% of pregnant women.
Conclusion Among isolated bacteria, 16.38% of them are part of group B streptococci that 14.89% of them are clindamycin induced resistance and 38.6% of them have concurrent resistance to erythromycin and clindamycin.
CITATION LINKS
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[15]Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L, Nadisauskiene R. Prevalence of maternal group B Streptococcal colonisation in European countries. Acta Obstet Gynecol. 2008;87(3):260-71.
[16] Hamedi A, Akhlaghi F, Seyedi SJ, Kharazmi A. Evaluation of group B Streptococci colonization rate in pregnant women and their newborn. Acta Med Iran. 2012;50(12):805-8.
[17]Capanna F, Emonet SP, Cherkaoui A, Irion O, Schrenzel J, Martinez de Tejada Weber B. Antibiotic resistance patterns among group B Streptococcus isolates: implications for antibiotic prophylaxis for early-onset neonatal sepsis. Swiss Med Wkly. 2013;143:w13778.
[18]Fatemi F, Chamani-Tabriz L, Pakzad P, Zeraati H, Rabbani H, Asgari S. Colonization rate of group B Streptococcus (GBS) in pregnant women using GBS agar medium. Acta Med Iran. 2009;47(1):25-30.
[19]Jannati E, Roshani M, Arzanlou M, Habibzadeh S, Rahimi G, Shapuri R. Capsular serotype and antibiotic resistance of group B Streptococci isolated from pregnant women in Ardabil, Iran. Iran J Microbiol. 2012;4(3):130-5.
[20]Janapatla RP, Ho YR, Yan JJ, Wu HM, Wu JJ. The prevalence of erythromycin resistance in group B Streptococcal isolates at a University Hospital in Taiwan. Microb Drug Resist. 2008;14(4):293-7.
[2] Andrews JI, Diekema DJ, Hunter SK, Rhomberg PR, Pfaller MA, Jones RN, et al. Group B Streptococci causing neonatal bloodstream infection: antimicrobial susceptibility and serotyping results from SENTRY centers in the Western Hemisphere. Am J Obstet Gynecol. 2000;183(4):859-62.
[3]Anthony BF. Carriage of group B Streptococci during pregnancy: a puzzler. J Infect Dis. 1982;145(6):789-93.
[4]World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes. Geneve: World Health Organization; 2015.
[5]Baker CJ, Barrett FF. Transmission of group B Streptococci among parturient women and their neonates. J Pediatr. 1973;83(6):919-25.
[6]Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B Streptococcal disease: revised guidelines from CDC, 2010 [Internet]. Centers for Disease Control and prevention. 2010;59(RR10):1-32.
[7]Bergseng H, Rygg M, Bevanger L, Bergh K. Invasive group B Streptococcus (GBS) disease in Norway 1996-2006. Eur J Clin Microbiol Infect Dis. 2008;27(12):1193-9.
[8]Aali BS, Abdollahi H, Nakhaee N, Davazdahemami Z, Mehdizadeh A. The association of preterm labor with vaginal colonization of group B Streptococci. Int J Reprod Biomed. 2007;5(4):191-4.
[9]Castor ML, Whitney CG, Como-Sabetti K, Facklam RR, Ferrieri P, Bartkus JM, et al. Antibiotic resistance patterns in invasive group B Streptococcal isolates. Infect Dis Obstet Gynecol. 2008;2008:727505.
[10]Desjardins M, Delgaty K, Ramotar K, Seetaram C, Toye B. Prevalence and mechanisms of erythromycin resistance in group A and group B Streptococcus: implications for reporting susceptibility results. J Clin Microbiol. 2004;42(12):5620-3.
[11]Onipede AO, Onayade AA, Elusiyan JB, Obiajunwa PO, Ogundare EO, Olaniran OO, et al. Invasive bacteria isolates from children with severe infections in a Nigerian hospital. J Infect Dev Ctries. 2009;3(6):429-36.
[12]DiPersio LP, DiPersio JR. High rates of erythromycin and clindamycin resistance among OBGYN isolates of group B Streptococcus. Diagn Microbiol Infect Dis. 2006;54(1):79-82.
[13] Kalantar E. High burden of group B Streptococcus: an invasive bacterium among pregnant women referring to health centers of Sanandaj, Iran. Infect Epidemiol Med. 2013;1(1):15-8.
[14]Figueira-Coelho J, Ramirez M, Salgado MJ, Melo-Cristino J. Streptococcus agalactiae in a large Portuguese teaching hospital: antimicrobial susceptibility, serotype distribution, and clonal analysis of macrolide-resistant isolates. Microb Drug Resist. 2004;10(1):31-6.
[15]Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L, Nadisauskiene R. Prevalence of maternal group B Streptococcal colonisation in European countries. Acta Obstet Gynecol. 2008;87(3):260-71.
[16] Hamedi A, Akhlaghi F, Seyedi SJ, Kharazmi A. Evaluation of group B Streptococci colonization rate in pregnant women and their newborn. Acta Med Iran. 2012;50(12):805-8.
[17]Capanna F, Emonet SP, Cherkaoui A, Irion O, Schrenzel J, Martinez de Tejada Weber B. Antibiotic resistance patterns among group B Streptococcus isolates: implications for antibiotic prophylaxis for early-onset neonatal sepsis. Swiss Med Wkly. 2013;143:w13778.
[18]Fatemi F, Chamani-Tabriz L, Pakzad P, Zeraati H, Rabbani H, Asgari S. Colonization rate of group B Streptococcus (GBS) in pregnant women using GBS agar medium. Acta Med Iran. 2009;47(1):25-30.
[19]Jannati E, Roshani M, Arzanlou M, Habibzadeh S, Rahimi G, Shapuri R. Capsular serotype and antibiotic resistance of group B Streptococci isolated from pregnant women in Ardabil, Iran. Iran J Microbiol. 2012;4(3):130-5.
[20]Janapatla RP, Ho YR, Yan JJ, Wu HM, Wu JJ. The prevalence of erythromycin resistance in group B Streptococcal isolates at a University Hospital in Taiwan. Microb Drug Resist. 2008;14(4):293-7.