Identification of inducible clindamycin resistance gene in Streptococcus agalactiae isolates colonizing pregnant women in Suez Canal University Hospitals

Document Type : Original Article


1 Microbiology and Medical Immunology Department Faculty of Medicine Suez Canal University- Ismailia, Egypt

2 Microbiology and Medical Immunology Department faculty of Medicine Suez Canal University - Ismailia

3 Obstetrics and Gynaecology department faculty of Medicine Suez Canal University - Ismailia


Background:  Streptococcus agalactiae is classified as group B Streptococci (GBS) according to Lancefield classification, GBS resides as one of commensals of both genitourinary and gastrointestinal tracts of humans. GBS affects mainly immunocompromised people particularly neonates. An increased rates of macrolides and lincosamides resistance have been noted, which is associated with expression of erm genes, resulting in erythromycin and inducible clindamycin resistance. Aim: To limit Group B Streptococcus transmission to neonates and reduce neonatal morbidity and mortality rates in Suez Canal University Hospitals. Methods: 204 clinical vaginal swabs were collected from pregnant women admitted to obstetrics and gynaecology department in Suez Canal University hospitals. Swabs were incubated for 24 hours in lim’s selective broth and then for isolation on Colombia blood agar, then identification by colony morphology, Gram staining and biochemical reactions were done. Antimicrobial susceptibility testing of the isolates was performed to penicillin G, ampicillin, vancomycin, levofloxacin, cefotaxime, erythromycin and clindamycin by disk diffusion method and D test was then performed. conventional PCR was used to detect ermA gene. Results: Out of 204 specimens, 54 S. agalactiae isolates were isolated with prevalence of 26.47%. All S. agalactiae isolates were sensitive to penicillin G (100%). Out of the 33 erythromycin-resistant isolates, 5 isolates showed inducible phenotype, and 4 of them had ermA gene (80%). Conclusions: In this study, the prevalence of S. agalactiae was remarkable and antibiogram is mandatory to detect the inducible resistance phenotype. Further studies are needed to provide a comprehensive data about S. agalactiae sensitivity profile to antibiotics in other health care facilities to reduce neonatal morbidity and mortality.


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