Antimicrobial susceptibility and genetic diversity of Streptococcus agalactiae recovered from newborns and pregnant women in Brazil

Background: Streptococcus agalactiae is known to be the major cause of neonatal infections and also causes complications during pregnancy. Methods: One hundred and six strains of Streptococcus agalactiae recovered from clinical specimens of newborns (n = 18) and pregnant women (n = 88) were submitted to antimicrobial susceptibility testing and investigation of genetic determinants of macrolide resistance, capsular type, and virulence factors. Genetic diversity was evaluated by pulsed-field gel electrophoresis (PFGE) analysis. Results: Strains were susceptible to ceftriaxone, levofloxacin, penicillin G, and vancomycin and resistant to tetracycline (85.8%) and erythromycin (4.7%). Erythromycin-resistant strains presented iMLS B phenotype, harbored the ermA gene, and were closely related by PFGE. Both bac and bca genes were found in low frequencies. PFGE analysis yielded 11 DNA restriction profiles among 35 selected isolates. The major clonal group, designated as A, was composed predominantly of strains belonging to capsular type Ia. Clonal group B was composed predominantly of strains with capsular type V, including all erythromycin-resistant isolates. Conclusions: Although low levels of erythromycin resistance have been observed, this is a fact of concern because this phenotype also confers resistance to clindamycin, an alternative agent for intrapartum prophylaxis. Despite the diversity of capsular types, Ia and V were among the most common and were significantly associated with distinct clonal groups. In a few cases, different capsular types were clustered into a single clonal group, which may be related to capsular switching.