RT Journal Article SR Electronic(1) A1 Garland, Suzanne M. A1 Cottrill, Erin A1 Markowski, Lisa A1 Pearce, Chris A1 Clifford, Vanessa A1 Ndisang, Daniel A1 Kelly, Nigel A1 Daley, Andrew J.YR 2011 T1 Antimicrobial resistance in group B streptococcus: the Australian experience JF Journal of Medical Microbiology, VO 60 IS 2 SP 230 OP 235 DO https://doi.org/10.1099/jmm.0.022616-0 PB Microbiology Society, SN 1473-5644, AB Intrapartum chemoprophylaxis for pregnant group B streptococcus (GBS) carriers reduces vertical transmission, with a resultant decrease in neonatal as well as maternal morbidity from invasive GBS infection. Current Australian guidelines recommend penicillin for intrapartum prophylaxis of GBS carriers, with erythromycin or clindamycin for those with a β-lactam allergy. Recent reports globally suggest that resistance to erythromycin and clindamycin may be increasing; hence, a study was undertaken to promote an evidence base for local clinical guidelines. Samples collected for standardized susceptibility testing included 1160 invasive GBS isolates (264 isolates retrospectively from 1982 to 2001 and prospectively from 2002 to 2006, plus 896 prospectively collected colonizing GBS isolates gathered over a 12 month period from 2005 to 2006) from 16 laboratories around Australia. All isolates displaying phenotypic macrolide or lincosamide resistance were subsequently genotyped. No isolates showed reduced susceptibility to penicillin or vancomycin. Of the invasive isolates, 6.4 % demonstrated phenotypic erythromycin resistance and 4.2 % were clindamycin resistant. Of the erythromycin-resistant isolates, 53 % showed cross-resistance to clindamycin. Very similar results were found in colonizing specimens. There was no statistically significant change in macrolide-resistance rates over the two study periods 1982–2001 and 2002–2006. Genotyping for macrolide and lincosamide-resistant isolates was largely consistent with phenotype. These findings suggest that penicillin therapy remains an appropriate first-line antibiotic choice for intrapartum GBS chemoprophylaxis, with erythromycin and/or clindamycin resistance being low in the Australian population. It would, nevertheless, be appropriate for laboratories screening for GBS in obstetric patients to consider macrolide sensitivity testing, particularly for those with β-lactam allergy, to ensure appropriate chemoprophylaxis., UL https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.022616-0