Serotypes and antibiotic resistance in Group B streptococcus isolated from patients at the Maternity Hospital, Kuwait

A total of 143 group B streptococcus (GBS) isolates collected from mothers at the Maternity Hospital in Kuwait were investigated for their serotypes and antibiotic resistance, and screened by PCR for the carriage of genes for resistance to tetracycline (tetk, tetM, tetL, tet0), erythromycin (ermA, ermB, ermC, ermTR, ermM, mefA, mefE, msrA) and aminoglycosides (aph3, ant4, ant6). All isolates were serotyped using a latex agglutination test. Most of the isolates belonged to serotypes V (38.5%), III (20.9%), la (7.7%) and II (11.2%). Sixteen isolates (11.2%) were nontypable. All isolates were susceptible to penicillin, ampicillin and cefotaxime (MICs 0.016-0.094 mu g ml(-1)) but were resistant to trimethoprim (92.3%), tetracycline (89.5%), minocycline (89.5%), high-level kanamycin (76.9%), chloramphenicol (30.0%), erythromycin (12.6%), clindamycin (7.0%), high-level streptomycin (3.5%) and ciprofloxacin (0.7%). The tetracycline-resistant isolates contained tetM (94.5%), tet0 (3.9%), tetL (1.6%) and tetK (0.8%). The erythromycin-resistant isolates contained ermB (61.1%), ermTR (38.9%), ermA (5.5%), mefA (5.5%) and mefE (11%). All high-level kanamycin-resistant isolates contained aph3. One of the high-level streptomycin-resistant isolates contained ant6. Partial DNA sequencing of aph3 revealed sequences with 99% similarity to aph3 found in Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis, suggesting that the GBS isolates could have acquired aph3 from other Gram-positive cocci. The high proportion of isolates with resistance to tetracycline, high-level kanamycin and trimethoprim, and the increase in the prevalence of erythromycin resistance, represents an emerging public health concern that needs further surveillance.