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Vaginal Group B Strep (GBS)
Antibiotic Resistance by PCR |
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Group B Streptococcus (GBS) is the leading causes of neonatal bacterial infection. A reported 10% to 30% of pregnant woman are colonized vaginally and/or rectally and thus have the potential to infect their newborn upon birth. A neonate who contracts GBS from their colonized mother can result in a number of serious types of infection such as pneumonia, septicemia, and/or meningitis. Because of the serious nature of neonatal GBS infections, the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics (AAP) suggest that all pregnant women should be tested for the presence of GBS at 35-37 weeks of gestation. Twenty-seven percent of pregnant women are administered antibiotics during labor and delivery to prevent transmission. The typical treatment for these patients is penicillin G of which there is no known resistance. However, up to 12% of the population reports allergies to penicillin. Therefore the macrolide (erythromycin) or lincosamide (clindamycin) classes of drugs need to be administered, particularly for those patients who are at high risk for anaphylactic shock. Previous reports cite an increase in resistance of GBS to erythromycin and clindamycin. For instance, in 2003, resistance to erythromycin and clindamycin was reported as high as 37% and 17% respectively.
The antibiotic resistance mechanisms are most commonly caused by three genes: ermB, ermTR, and mefA. MDL concluded a study where both the Clinical and Laboratory Standards Institute (formerly NCCLS) 2003 "Performance Standards for Antimicrobial Susceptibility Testing" protocols and a multiplex PCR assay were used to screen for the prevalence of these genes in 222 GBS clinical isolates. These isolates were obtained from MDL's clinical swab samples. Of the 222 GBS clinical isolates, 84 strains (38%) were resistant to erythromycin and 46 strains (21%) were resistant to clindamycin. The multiplex PCR proved to be an efficient method to identify the three major antibiotic resistance genes in GBS. With the presence of these genes on mobile genetic elements such as plasmids and/or transposons, the passing of these genes from bacteria to bacteria is likely and should be monitored to provide the physician with the vital information needed for proper patient treatment.
MDL has developed a highly sensitive and specific multiplex polymerase chain reaction to identify GBS antibiotic resistance genes from GBS clinical isolates. This new test is now available from the  .
Vaginal Group B Strep (GBS) Antibiotic Resistance by PCR test description |
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