Infect Chemother.  2013 Sep;45(3):299-307. 10.3947/ic.2013.45.3.299.

Risk Factors Associated with Group B Streptococcus Resistant to Clindamycin and Erythromycin in Pregnant Korean Women

Affiliations
  • 1Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
  • 2Department of Preventive Medicine, Eulji University Hospital, Eulji University, Daejeon, Korea. moranki@naver.com
  • 3Department of Obstetrics and Gynecology, Eulji University Hospital, Eulji University, Daejeon, Korea.
  • 4Department of Obstetrics and Gynecology, Eulji General Hospital, Eulji University, Seoul, Korea.
  • 5Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor, USA.

Abstract

BACKGROUND
The prevalence of group B streptococcus (GBS) among pregnant women and neonates in the Republic of Korea has increased. In addition, rates of resistance to antibiotics recommended for pregnant women allergic to penicillin, such as clindamycin and erythromycin, have increased. The aim of this study was to evaluate subject characteristics associated with GBS resistance to clindamycin and erythromycin.
MATERIALS AND METHODS
A total of 418 clinical isolates from pregnant women in Korea were screened for antibiotic resistance from January 2006 to December 2011. Sociodemographic information, medical and obstetric history, and details of events during the previous 2 weeks were recorded using a standardized questionnaire.
RESULTS
The resistance rates were 39.5% for clindamycin and 23.0% for erythromycin. In multiple logistic regression analysis, the subject characteristic significantly associated with resistance to both antibiotics was a history of symptomatic sore throat in the 2 weeks before obtaining the specimen (erythromycin: odds ratio [OR]: 2.13, 95% confidence interval [CI]: 1.10 to 4.13; clindamycin: OR: 2.31, 95% CI: 1.21, 4.42). Premature rupture of membranes (PROM) had an association of borderline significance.
CONCLUSIONS
In the urgent treatment of GBS-colonized pregnant women, the subject's history of previous sore throat and PROM should be considered when choosing appropriate antibiotics.

Keyword

Antibiotic resistance; Clindamycin; Erythromycin; Risk factors; Streptococcus agalactiae
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