Pearlman M D, Pierson C L, Faix R G
Department of Obstetrics and Gynecology, The University of Michigan Health System, Ann Arbor 48109-0276, USA.
Obstet Gynecol. 1998 Aug;92(2):258-61. doi: 10.1016/s0029-7844(98)00155-0.
To determine both the frequency of reported penicillin allergy in parturients and the frequency of resistance in vitro of clinical isolates of group B streptococci to clindamycin and erythromycin.
One hundred clinical isolates of group B streptococci were tested to determine the frequency of resistance to clindamycin, erythromycin, penicillin G, vancomycin, and cefazolin. The frequency of beta-lactam allergy and reported allergic reaction also were recorded for all consecutive laboring women during the 4-month study.
The frequency of group B streptococcal resistance to clindamycin was 15% and to erythromycin was 16%. No isolates were resistant to penicillin G, vancomycin, or cefazolin. Twelve percent of the 963 women who delivered during the study reported a penicillin allergy, but only 30% of those could describe their allergic reaction.
In vitro resistance of group B streptococci to clindamycin and erythromycin occurred frequently in this population. Whereas the importance of this finding in vivo is uncertain, it raises concern about the possibility of inadequate prophylaxis using currently recommended alternatives in penicillin-allergic patients. Artful questioning of women reporting penicillin allergy may lessen the likelihood of using these less desirable agents in the setting of intrapartum antimicrobial prophylaxis.
确定产妇中报告的青霉素过敏频率以及B族链球菌临床分离株对克林霉素和红霉素的体外耐药频率。
检测100株B族链球菌临床分离株，以确定对克林霉素、红霉素、青霉素G、万古霉素和头孢唑林的耐药频率。在为期4个月的研究中，还记录了所有连续分娩妇女的β-内酰胺过敏频率和报告的过敏反应。
B族链球菌对克林霉素的耐药频率为15%，对红霉素的耐药频率为16%。没有分离株对青霉素G、万古霉素或头孢唑林耐药。在研究期间分娩的963名妇女中，12%报告有青霉素过敏，但其中只有30%能描述其过敏反应。
该人群中B族链球菌对克林霉素和红霉素的体外耐药情况频繁发生。虽然这一发现在体内的重要性尚不确定，但它引发了人们对青霉素过敏患者使用当前推荐替代药物进行预防可能不足的担忧。对报告有青霉素过敏的妇女进行巧妙询问，可能会降低在产时抗菌药物预防中使用这些不太理想药物的可能性。
