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Can we use erythromycin or clindamycin in penicillin-allergic patients with vaginal and anorectal carriage of Streptococcus agalactiae in late pregnancy?

Abstract number: 1733_828

Khorvash F., Javadi A., Izadi M., Mobasherizadeh S., Mostafavizadeh K., Ahmadi M.

Objective: The aim of this study was to establish the incidence and frequency of Group B Streptococcus (GBS) colonisation in pregnant women and to determine antibiotic susceptibility and policies for prevention of neonatal GBS infection in Isfahan, Iran.

Methods: A total of 170 pregnant women at 35–37 weeks of gestation were screened by placement of a swab in the lower third of the vagina with subsequent passage across the perineum and anus. GBS was identified via colonial morphology, beta-haemolytic, and biochemical reactions. The antimicrobial susceptibility test was performed by the agar dilution method.

Results: The prevalence of vaginal and rectal GBS colonisation was 18.2%. Colonisation rates were significantly increased among multi parity (p = 0.04), and antecedent abortion (p = 0.01). There were no significant differences between age, socioeconomic condition and GBS colonisation. All strains were susceptible to penicillin, ampicillin, vancomycin, cephazolin and imipenem. Thirteen (41.9%) isolates were resistant to erythromycin (MIC ≥ 1 g/L) and eight (25.8%) were resistant to clindamycin (MIC ≥ 1 g/L). Two strains (6.4%) showed intermediate susceptibility to clindamycin (MIC = 0.5 g/L). 87% of strains were resistant to gentamicin.

Conclusion: The colonisation rate of GBS among pregnant women in the present study is high, and on the basis of documented benefits of antenatal screening in western countries we recommend routine screening, especially for our at risk patients. According to high resistant to erythromycin and clindamycin in our population we recommended that for allergic penicillin patients use of these antibiotics should be done after identifying of sensitivity in laboratory.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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