title: Changing Epidemiology of Group B Streptococcus Susceptibility to Fluoroquinolones and Aminoglycosides in France.
abstract: Group B Streptococcus (GBS) is the leading cause of neonatal invasive infections and an emerging pathogen in the elderly. Our objectives were to describe the evolution of GBS resistance to antibiotics in France and to investigate the emergence of fluoroquinolone (FQ)-resistant isolates. A total of 8,757 unrelated GBS isolates were collected and tested for antibiotic susceptibility from 2007 to 2014 according to EUCAST recommendations. All isolates were susceptible to penicillin G, amoxicillin, and vancomycin. Resistance to macrolides decreased from 47.0% to 30.0%, whereas high-level resistance to aminoglycosides, especially amikacin, increased from 6.4% to 8.8% and 24 isolates (0.3%) were highly resistant to gentamicin. FQ resistance gradually increased from 0.2% in 2007 (n = 1) to 1.5% in 2014 (n = 18, P < 0.01). Capsular polysaccharide (CPS) genotyping, multilocus sequence typing, and sequencing of the quinolone resistance-determining region (QRDR) showed that GBS isolates of sequence type 19 (ST-19) CPS type V were largely overrepresented in FQ-resistant isolates (n = 30, 45.5%). All 30 strains displayed the same QRDR mutations and were often associated with cross-resistance to macrolides (93.3%) and gentamicin (30%). In conclusion, we report the rise of FQ- and aminoglycoside-resistant GBS in France over an 8-year study period, an evolution likely linked to the clonal expansion of ST-19 CPS V-resistant isolates. This study emphasizes the need for a continuous surveillance of GBS epidemiology and antibiotic susceptibility.
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France.|Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|INSERM U 1016, Institut Cochin, Team "Barriers and Pathogens," Paris, France.|CNRS UMR 8104, Paris, France.
authors.forename: Constantin
authors.initials: C
authors.lastname: Hays
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Louis
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France.|Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|INSERM U 1016, Institut Cochin, Team "Barriers and Pathogens," Paris, France.|CNRS UMR 8104, Paris, France.|Centre National de Référence des Streptocoques, Paris, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Plainvert
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France.|Centre National de Référence des Streptocoques, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dmytruk
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France.|Centre National de Référence des Streptocoques, Paris, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Touak
authors.affiliation: Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, Paris, France.|CNRS ERL3526, Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Trieu-Cuot
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France.|Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|INSERM U 1016, Institut Cochin, Team "Barriers and Pathogens," Paris, France.|CNRS UMR 8104, Paris, France.|Centre National de Référence des Streptocoques, Paris, France.|Institut Pasteur, Unité de Biologie des Bactéries Pathogènes à Gram Positif, Paris, France.|CNRS ERL3526, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Poyart
authors.affiliation: Service de Bactériologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre Site Cochin, Paris, France asmaa.tazi@aphp.fr.|Université Paris Descartes, Sorbonne Paris Cité, Paris, France.|INSERM U 1016, Institut Cochin, Team "Barriers and Pathogens," Paris, France.|CNRS UMR 8104, Paris, France.|Centre National de Référence des Streptocoques, Paris, France.
authors.forename: Asmaa
authors.initials: A
authors.lastname: Tazi
mesh_terms: D000328:Adult; D000617:Aminoglycosides / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002999:Clone Cells; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology; D005602:France / Q000453:epidemiology; D015870:Gene Expression; D005798:Genes, Bacterial; D006761:Hospitals; D006801:Humans; D007223:Infant; D018942:Macrolides / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D009154:Mutation; D011247:Pregnancy; D017422:Sequence Analysis, DNA; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D018942:Macrolides