The National Institute of Biotechnology Information considers Streptococcus agalactiae to be the leading cause of brain and blood infections in newborns. Neonates and infants acquire these infections while passing through the birth canal or when in close contact with individuals who carry this bacteria in their body. Additionally, Streptococcus agalactiae can also cause of serious urinary tract and soft tissue infections as well as life-threatening blood and brain infections in immunocompromised individuals. Early diagnosis and treatment with antibiotics is crucial to prevent complications.
Penicillin
According to a paper presented by Dr. F. Cavallini at the 16th European Congress for Clinical Microbiology and Infectious Diseases, penicillin and its derivative ampicillin remain the drugs of choice to treat Streptococcus agalactiae infections, with less than 2 percent strains reporting resistance to these antibiotics.
Intravenous administration of penicillin every 4 to 6 hours for 2 to 6 weeks can be given to neonates, infants and immunocompromised adults who suffer from life threatening conditions.
Penicillin allergies are, however, common and are characterized by hives, rash, swollen face, difficult breathing or weak pulse. These should be immediately addressed as they are potentially fatal.
Clindamycin
Clindamycin is commonly used to treat Streptococcus agalactiae infections in patients with penicillin allergies and works by slowing or stopping the growth of the bacteria. Clindamycin may also be given intravenously to neonates, infants and immunocompromised adults with severe infections. Side effects are mild and include nausea, vomiting, rash, joint pain or heart burn.
Clindamycin resistance is, however, fairly prevalent among the pathogenic strains of Streptococcus agalactiae. In fact, in a July 2005 study published in the Clinical Microbiology Infections, Dr. TE Schoening states that almost 11 percent strains of Streptococcus agalactiae were resistant to clindamycin.
Vancomycin
The Center for Disease Control recommends the use of vancomycin only to treat clindamycin resistant strains in individuals with penicillin allergies. However, in an article published in the September 2009 edition of the Journal of Perinatal Medicine, Dr. LM. Pelaez states that "Physician adherence to the CDC guidelines with regards to the use of vancomycin is far from optimal" with 87 percent of pregnant women receiving vancomycin for Streptococcus agalactiae without proper screening for clindamycin resistance.
Vancomycin can be taken orally or intravenously three to four times a day for 7 to 10 days depending on the condition of the patient. Common side effects include upset stomach and skin rash.
References
- Entrez Genome Project: Streptococcus agalactiae
- ESCMID: Penicillin resistance in Streptococcus agalactiae
- "Clinical Microbiology Infections"; Prevalence of erythromycin and clindamycin resistance among Streptococcus agalactiae isolates in Germany; Schoening TE, Wagner J and Arvand M; July 2005
- "Journal of Perinatal Medicine"; Inappropriate use of vancomycin for preventing perinatal group B streptococcal (GBS) disease in laboring patients.; Peláez LM, Gelber SE, Fox NS and Chasen ST; September 2009
