High rates of colonization and antimicrobial resistance of group B streptococcus highlight the need for vaccination even after implementation of guidelines for intrapartum antibiotic prophylaxis

• Published in: Vaccine Vol. 40; no. 2; pp. 282 - 287
• Main Authors: Wang, Ching-Hui, Kung, Wan-Ju, Lee, Chien-Hung, Lee, Cheng-Fa, Kao, Chia-Ling, Chen, Hui-Chi, Hsu, Ting-Wen, Lin, Ching-Chiang
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 21.01.2022; Elsevier Limited
• Subjects: Age; Aged; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Antibiotics; Antimicrobial agents; Antimicrobial resistance; Antimicrobial resistance (AMR); Babies; Childbirth & labor; Clindamycin; Clindamycin resistance; Colonization; Country of birth; Disease prevention; Drug resistance; Drug Resistance, Bacterial; Erythromycin; Erythromycin resistance; Ethnicity; Female; Group B streptococcus (GBS); Hospitals; Humans; Immigrant; Immigrants; Infant, Newborn; Infections; Infectious Disease Transmission, Vertical - prevention & control; Intrapartum antibiotic prophylaxis (IAP); Medical laboratories; Neonates; Newborn babies; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - prevention & control; Prophylaxis; Streptococcal Infections - drug therapy; Streptococcal Infections - epidemiology; Streptococcal Infections - prevention & control; Streptococcus; Streptococcus agalactiae; Streptococcus infections; Vaccination; Womens health; Taiwan; Indonesia; Group B streptococcus (GBS); Antimicrobial resistance (AMR); Erythromycin resistance; Intrapartum antibiotic prophylaxis (IAP); Immigrant; Clindamycin resistance
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2021.11.069

It is estimated that about 11–35% of pregnant women are colonized with Group B streptococcus. Intrapartum antibiotic prophylaxis (IAP) is the primary intervention to decrease the risk of infecting babies born to GBS colonized mothers. A total of 5,996 pregnant women, who received the Taiwanese universal GBS screening program from 2012 to 2020, were included in this study that investigated GBS colonization, antimicrobial resistance rates and their neonatal incidence of invasive GBS infection. The average GBS colonization rate was 18.5%. Older age groups had higher colonization rates than younger age groups. Compared to Taiwanese, immigrant women from Indonesia had a greater positive rate. GBS isolated from Vietnamese women had significant greater resistance to clindamycin relative to Taiwanese women. Rates of resistance to erythromycin increase from 35.5% to 45.5% over the 9 years of measurements. The incidence of invasive GBS disease was about 0.6/1,000 (4/6,204) live births during the study. Although relatively low incidence of invasive GBS diseases was observed after implementation of IAP, the colonization of GBS remains high and antimicrobial resistance of GBS is increasing. An effective GBS vaccine holds promise to be a solution for these issues.