Serotyping and Antibiotic Susceptibility of Invasive Streptococcus agalactiae in Egyptian Patients with or without Diabetes Mellitus

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  • 1 Department of Clinical Pathology, Al-Azhar University, Cairo, Egypt;
  • | 2 Al Borg Laboratory, Egypt;
  • | 3 Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 4 Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt;
  • | 5 Department of Tropical Medicine, Faculty of Medicine, AinShams University, Cairo, Egypt;
  • | 6 Hepatobiliary and Liver Transplant Surgery Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt;
  • | 7 Gastroenterology, Hepatology and Infectious Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt;
  • | 8 Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt;
  • | 9 Faculty of Medicine, Suez University, Suez, Egypt;
  • | 10 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt;
  • | 11 Department of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt

Streptococcus agalactiae serotype distribution and its antibiotic susceptibility affect disease prevention strategies, but the serotype distribution varies among patient groups. The objectives of this study were to establish the group B Streptococcus (GBS) serotype distribution in patients from Egypt and to assess antibiotic sensitivity of invasive GBS isolates. A total of 490 patients participated in this multicenter study; 160 had urinary tract infection, 115 complained of diabetic foot ulcers, 125 men had genital tract infections, and 30 women females had genital tract infections. Others had bronchopneumonia, otitis media, synovitis, or meningitis. Serotyping of the isolated GBS was performed at the CDC in the United States. Antibiotic sensitivity patterns were determined using the disk diffusion method. In men, the most common serotypes were II, III, and V, whereas types Ia, II, III, and V were isolated from women. Macrolides (erythromycin) resistance occurred in 4.1% of the isolates; 10.2% were resistant to both clindamycin and inducible resistance of macrolides, lincomycin, and streptogramin; 17.3% were resistant to quinolones; and 95.9% were resistant to tetracyclines. GBS primarily infected the urinary tract, skin, soft tissue, and genital tract in both genders. Isolates were sensitive to beta-lactam drugs, vancomycin, and linezolid; 14.0% were resistant to macrolides with or without clindamycin. Only 6.0% of the strains were sensitive to tetracyclines. Although GBS causes invasive infections in Egyptian adults, it rarely causes neonatal meningitis or sepsis. Future studies should determine whether GBS isolates are transmitted sexually, by performing a follow-up study of the partner of the infected patient.

Author Notes

Address correspondence to Abd-ElAleem A. El-Gendy, Faculty of Medicine, Al-Azhar University, Almokhayam Aldaaem St., 11884, Nasr City, Cairo, Egypt. E-mail: abdelaleemelgendy2000@gmail.com

Authors’ addresses: Abd-ElAleem A. El-Gendy and Mohamed El-Tonsy El-Sayed, Department of Clinical Pathology, Al-Azhar University, Cairo, Egypt, E-mails: abdelaleemelgendy2000@gmail.com and XXXXX. Sawsan H. M. El Tayeb Hassan, Department of Clinical Pathology, Al-Azhar University, Cairo, Egypt, and Al Borg Laboratory, Egypt, E-mail: XXXXX. Bob Gertz and Beal Bernard, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: XXXXX and XXXXX. Mohamed Meligy Ahmed, Hassan Ahmed Elzohry, and Mohamed Fathey Elgazzar, Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt, E-mails: mmelegy2013@gmail.com, elzohry2002@yahoo.com, and XXXXX. Ghada Abd El Tawab, Al Borg Laboratory, Egypt, E-mail: elgazzar_mohamed@yahoo.com. Shimaa Y. Kamel, Department of Tropical Medicine, Faculty of Medicine, AinShams University, Cairo, Egypt, E-mail: XXXXX. Hazem Zakaria, Hepatobiliary and Liver Transplant Surgery Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt, E-mail: hazemlasheenn@yahoo.com. Aya Mohammed Mahros and Mohammed Hussien Ahmed, Gastroenterology, Hepatology and Infectious Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt, E-mails: yoye_85@hotmail.com and dr.mm63@yahoo.com. Marwa Ali Tahoon, Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt, E-mail: marwa.123ali@yahoo.com. Mohamed A. Sakr, Faculty of Medicine, Suez University, Suez, Egypt, E-mail: msakr.md@gmail.com. Abdelnaser Abdelaty Gadallah, Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt, E-mail: XXXXX. Fatma Eldesoky Ahmed, Department of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt, E-mail: fatma.shehata@med.menofia.edu.eg.

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