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옥지형,김문영,김은주,양재혁,류현미,오관영,신정환,Betsy Foxman,기모란 대한감염학회 2013 Infection and Chemotherapy Vol.45 No.3
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 2weeks 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.
Changing Molecular Epidemiology of Group B Streptococcus in Korea
서용수,Usha Srinivasan,오관영,신정환,채정돈,김문영,양재혁,윤혜령,Brady Miller,Joan DeBusscher,Betsy Foxman,기모란 대한의학회 2010 Journal of Korean medical science Vol.25 No.6
The prevalence of group B streptococcus (GBS) among pregnant women and disease burdens in neonates and adults are increasing in Korea. Colonizing isolates,collected by screening pregnant women (n=196), and clinical isolates collected from clinical patients throughout Korea (n=234), were serotyped and screened for antibiotic resistance. Serotype III (29.8%) and V (27.7%) predominated, followed by Ia (17.0%). Antibiotic resistance was higher among clinical than colonizing isolates for erythromycin (35.1% and 26.9%; P=0.10) and for clindamycin (49.4% and 42.1%;P=0.17). erm(B) occurred in 91.9% of erythromycin resistant isolates, and 84.0%of isolates resistant to clindamycin. Only five isolates (4.2%) resistant to erythromycin were susceptible to clindamycin; by contrast, and unique to Korea, 34% of isolates resistant to clindamycin were erythromycin susceptible. Among these 60 erythromycin-susceptible & clindamycin-resistant isolates, 88% was serotype III, and lnu(B)was found in 89% of strains. Four fifths of the serotype V isolates were resistant to both erythromycin and clindamycin. Further characterization of the genetic assembly of these resistance conferring genes, erm(B) and lnu(B), will be useful to establish the clonal lineages of multiple resistance genes carrying strains.
Risk Factors for Group B Streptococcus Colonization Among Pregnant Women in Korea
Eun Ju Kim,오관영,김문영,서용수,Jung-Hwan Shin,Young Rae Song,Jae-Hyug Yang,Betsy Foxman,기모란 한국역학회 2011 Epidemiology and Health Vol.33 No.-
OBJECTIVES: To identify obstetric and maternal factors related to Group B Streptococcus (GBS) colonization in pregnant women in Korea. METHODS: The study was conducted between the years 2006-2008 in four hospitals, Cheil and Eulji hospital in Seoul, and Motae and Eulji hospital in Daejeon. We recruited 2,644 pregnant women between 35 to 37 weeks of gestation who had visited for antenatal care. Participants completed a questionnaire, and urine, vaginal and rectal specimens were obtained and cultured using selective broth media. After delivery, medical records were reviewed. RESULTS: GBS colonization was significantly associated with hospital, age group, education, frequency of pregnancy, and premature rupture of membranes (PROM, more than 18 hours). After adjustment for other variables, Cheil hospital (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.20-3.52), and the first pregnancy (OR, 2.32; 95% CI, 1.12-4.81) remained significant. History of vaginitis showed marginal significance (OR, 1.50; 95% CI, 0.98-2.29). CONCLUSION: To prevent GBS infection of neonates, clinicians should be alert to the potentially higher risk of GBS colonization in pregnant women in their first pregnancy, and women with premature rupture of membranes (PROM) (18 hours+) or who have a history of vaginitis.
Changing Molecular Epidemiology of Group B Streptococcus in Korea
Seo, Yong Soo,Srinivasan, Usha,Oh, Kwan-Young,Shin, Jung-Hwan,Chae, Jeong Don,Kim, Moon Young,Yang, Jae Hyug,Yoon, Hye-Ryung,Miller, Brady,DeBusscher, Joan,Foxman, Betsy,Ki, Moran The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.6
<P>The prevalence of group B streptococcus (GBS) among pregnant women and disease burdens in neonates and adults are increasing in Korea. Colonizing isolates, collected by screening pregnant women (n=196), and clinical isolates collected from clinical patients throughout Korea (n=234), were serotyped and screened for antibiotic resistance. Serotype III (29.8%) and V (27.7%) predominated, followed by Ia (17.0%). Antibiotic resistance was higher among clinical than colonizing isolates for erythromycin (35.1% and 26.9%; <I>P</I>=0.10) and for clindamycin (49.4% and 42.1%; <I>P</I>=0.17). <I>erm</I>(B) occurred in 91.9% of erythromycin resistant isolates, and 84.0% of isolates resistant to clindamycin. Only five isolates (4.2%) resistant to erythromycin were susceptible to clindamycin; by contrast, and unique to Korea, 34% of isolates resistant to clindamycin were erythromycin susceptible. Among these 60 erythromycin-susceptible & clindamycin-resistant isolates, 88% was serotype III, and <I>lnu</I>(B) was found in 89% of strains. Four fifths of the serotype V isolates were resistant to both erythromycin and clindamycin. Further characterization of the genetic assembly of these resistance conferring genes, <I>erm</I>(B) and <I>lnu</I>(B), will be useful to establish the clonal lineages of multiple resistance genes carrying strains.</P>