title: Correlates of antibiotic-resistant group B streptococcus isolated from pregnant women.
abstract: Despite antibiotic prophylaxis for at-risk mothers during labor and delivery, group B streptococcus still causes substantial morbidity and mortality among newborns. Resistance to antibiotics recommended for penicillin-allergic pregnant women, such as erythromycin and clindamycin, has increased. A better understanding of factors associated with group B streptococcus resistance is essential to effectively prevent group B streptococcus disease.A total of 117 sequential group B streptococcus isolates were obtained between August 1999 and March 2000 from pregnant women at the University of Michigan Medical Center. Serotype and susceptibility to ten antimicrobials using disk diffusion with E-test for confirmation were determined, and the association between several host factors and colonization with a resistant strain was evaluated. Group B streptococcus was frequently resistant to erythromycin (29%) and clindamycin (21%) but was susceptible to all other antimicrobials tested. A stepwise logistic regression model revealed that black ethnicity (P =.02) and carriage of a serotype V strain (P =.01) were associated with group B streptococcus resistance. Among this population of pregnant women, black ethnicity and serotype V were the strongest predictors of colonization with an erythromycin- or clindamycin-resistant group B streptococcus strain. A better understanding of factors associated with antibiotic resistance is needed to minimize group B streptococcus disease risks and to maximize effective chemoprophylaxis.
authors.affiliation: Department of Epidemiology and Center for Molecular and Clinical Epidemiology of Infectious Diseases, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-0276, USA.
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Manning
authors.forename: Betsy
authors.initials: B
authors.lastname: Foxman
authors.forename: Carl L
authors.initials: CL
authors.lastname: Pierson
authors.forename: Patricia
authors.initials: P
authors.lastname: Tallman
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Baker
authors.forename: Mark D
authors.initials: MD
authors.lastname: Pearlman
mesh_terms: D000293:Adolescent; D000328:Adult; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000188:drug therapy*; D013292:Streptococcus agalactiae / Q000187:drug effects*