Clifford Vanessa, Heffernan Helen M, Grimwood Keith, Garland Suzanne
Royal Children's Hospital, Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2011 Aug;51(4):328-32. doi: 10.1111/j.1479-828X.2011.01302.x. Epub 2011 Mar 16.
Intrapartum chemoprophylaxis for group B streptococcus (GBS) carriers reduces the risk of early-onset neonatal GBS infection. For women with β-lactam allergy, either erythromycin or clindamycin are administered. Recent reports worldwide suggest that GBS resistance to these antibiotics is increasing.
To compare erythromycin and clindamycin resistance phenotypes in invasive neonatal GBS isolates across New Zealand and Australia over the past two decades and to determine whether regional variation in resistance patterns exist.
Invasive neonatal GBS isolates were collected from laboratories across New Zealand (n=107) and Australia (n=74) over two time periods (1992-1994 and 2002-2004 in New Zealand; 1982-2001 and 2002-2006 in Australia) and subjected to standard antibiotic susceptibility testing. A nested sub-study in New Zealand examined antibiotic susceptibilities of 112 maternal colonising GBS isolates during 2003-2004.
Erythromycin resistance among invasive neonatal GBS isolates increased across both countries over the past decade, with similar rates of resistance in New Zealand (9%) and Australia (6%) in recent years. New Zealand erythromycin-resistant GBS isolates commonly displayed cross-resistance to clindamycin. Also, there were significantly higher rates of isolated clindamycin resistance in GBS isolates from New Zealand than Australia (P=0.034). Maternal GBS isolates from New Zealand showed similar resistance patterns to neonatal isolates.
Erythromycin and clindamycin resistance among invasive neonatal GBS isolates has emerged in both New Zealand and Australia over the past decade and is consistent with global trends in GBS resistance patterns. Although regional variations exist, these findings should be considered when implementing intrapartum GBS prevention strategies.
对B族链球菌（GBS）携带者进行产时化学预防可降低早发型新生儿GBS感染的风险。对于有β-内酰胺类药物过敏的女性，可使用红霉素或克林霉素。全球近期报告表明GBS对这些抗生素的耐药性正在增加。
比较过去二十年间新西兰和澳大利亚侵袭性新生儿GBS分离株中红霉素和克林霉素的耐药表型，并确定耐药模式是否存在地区差异。
在两个时间段（新西兰为1992 - 1994年和2002 - 2004年；澳大利亚为1982 - 2001年和2002 - 2006年）从新西兰（n = 107）和澳大利亚（n = 74）各地的实验室收集侵袭性新生儿GBS分离株，并进行标准抗生素敏感性测试。新西兰的一项嵌套子研究检测了2003 - 2004年期间112株产妇定植GBS分离株的抗生素敏感性。
在过去十年中，两个国家侵袭性新生儿GBS分离株对红霉素的耐药性均有所增加，近年来新西兰（9%）和澳大利亚（6%）的耐药率相似。新西兰对红霉素耐药的GBS分离株通常对克林霉素也有交叉耐药性。此外，来自新西兰的GBS分离株中克林霉素耐药率显著高于澳大利亚（P = 0.034）。来自新西兰的产妇GBS分离株与新生儿分离株表现出相似的耐药模式。
在过去十年中，新西兰和澳大利亚侵袭性新生儿GBS分离株中均出现了对红霉素和克林霉素的耐药性，且与GBS耐药模式的全球趋势一致。尽管存在地区差异，但在实施产时GBS预防策略时应考虑这些发现。
