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Streptococcus agalactiae (group B streptococcus [GBS]) is the leading cause of neonatal and maternal sepsis. Penicillin is recommended for intrapartum prophylaxis, but erythromycin or clindamycin is used for penicillin-allergic carriers. Antibiotic resistance (AR) has increased recently and needs to be monitored. We have developed a multiplex PCR-based reverse line blot (mPCR/RLB) hybridization assay to detect, simultaneously, seven genes encoding AR—erm (A/TR),erm (B),mef (A/E),tet (M),tet (O),aphA-3 , andaad -6 —and two AR-related genes,int -Tn andmreA . We tested 512 GBS isolates from Asia and Australasia and compared mPCR/RLB with antibiotic susceptibility phenotype or single-gene PCR. Phenotypic resistance to tetracycline was identified in 450 (88%) isolates, of which 442 hadtet (M) (93%) and/ortet (O) (6%). Of 67 (13%) erythromycin-resistant isolates, 18 were susceptible to clindamycin, i.e., had the M phenotype, encoded bymef (A/E); 39 had constitutive (cMLSB ) and 10 inducible clindamycin resistance, and of these, 34 containederm (B) and 12erm (A/TR). Of four additional isolates withmef (A/E), three containederm (B) with cMLSB and one was erythromycin susceptible. Of 61 (12%) clindamycin-resistant isolates, 20 were susceptible to erythromycin and two had intermediate resistance. Based on sequencing, 21 of 22 isolates withmef hadmef (E), and 8 of 353 withint -Tn had an atypical sequence. Several AR genes,erm (B),tet (O),aphA-3 ,aad -6 , andmef (A/E), were significantly more common among Asian than Australasian isolates, and there were significant differences in distribution of AR genes between GBS serotypes. Our mPCR/RLB assay is simple, rapid, and suitable for surveillance of antibiotic resistance in GBS.

antimicrobial agents and chemotherapy

Simultaneous Detection of Nine Antibiotic Resistance-Related Genes in <i>Streptococcus agalactiae</i> Using Multiplex PCR and Reverse Line Blot Hybridization Assay

Simultaneous Detection of Nine Antibiotic Resistance-Related Genes in Streptococcus agalactiae Using Multiplex PCR and Reverse Line Blot Hybridization Assay