title: High rates of perinatal group B Streptococcus clindamycin and erythromycin resistance in an upstate New York hospital.
abstract: The objective of this study was to evaluate the rates of clindamycin and erythromycin resistance among group B Streptococcus (GBS)-positive isolates cultured from pregnant women in an upstate New York community hospital. All GBS-positive perinatal rectovaginal cultures obtained from January 2010 through October 2011 were tested for resistance to erythromycin and clindamycin. Among the 688 GBS-positive cultures, clindamycin resistance was found in 38.4% and erythromycin resistance was found in 50.7%. Rates of GBS resistance to clindamycin and erythromycin are much higher than reported in earlier U.S. studies, suggesting both increasing resistance and regional variation in resistance. These findings lend strong support to the CDC and American College of Obstetricians and Gynecologists (ACOG) recommendations that clindamycin use for intrapartum antibiotic prophylaxis be restricted to penicillin-allergic women at high risk of anaphylaxis and that GBS isolates be tested for antibiotic resistance prior to the use of clindamycin in these women.
authors.affiliation: Department of Family Medicine, Ellis Hospital, Schenectady, New York, USA. backe@ellismedicine.org
authors.forename: Ephraim E
authors.initials: EE
authors.lastname: Back
authors.forename: Elisa J
authors.initials: EJ
authors.lastname: O'Grady
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Back
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002981:Clindamycin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000494:pharmacology*; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D004917:Erythromycin