Increase in Penicillin Non-Susceptibility in Group B Streptococci Alongside Rising Isolation Rates-Based on 24 Years of Clinical Data from a Single University Hospital.

Abstract

Background/Objectives: Streptococcus agalactiae (Group B Streptococci, GBS) is Gram-positive, beta-hemolytic coccus known to be transmitted by vertical transmission in neonates during birth with neonatal sepsis, pneumonia, and meningitis. In adults, particularly the elderly and those with diabetes mellitus, GBS can also cause pneumonia and sepsis. Penicillin is the drug of choice, and GBS is generally susceptible to this antibiotic. This study investigates trends in GBS isolation rates and penicillin non-susceptibility over time at a university hospital. Methods: We retrospectively analyzed 24 years (2000-2023) of microbiological data from Ilsan Paik Hospital to investigate trends in GBS isolation and penicillin susceptibility. Isolates were identified and tested using the Vitek 2 system, following CLSI guidelines. WHONET 2023 was used for data aggregation and analysis. Trends were analyzed by dividing the study period into three intervals: Period 1 (2000-2009), Period 2 (2010-2019), and Period 3 (2020-2023). Antimicrobial susceptibility rates for total GBS and PCN-NS GBS (penicillin non-susceptible group B Streptococcus) were compared using chi-square tests. Results: Among 257,884 total isolates, 3003 (1.16%) were GBS, and 29 (0.97%) were PCN-NS. GBS and PCN-NS isolation rates increased significantly across the three periods (p = 0.0001 and p = 0.009, respectively). PCN-NS GBS showed reduced susceptibility to all tested antimicrobials, with no drug showing higher susceptibility compared to total GBS. Conclusions: This study demonstrates a statistically significant rise in both GBS isolation rate and penicillin non-susceptibility over time. Given the emergence of multidrug-resistant GBS strains, susceptibility testing and interdisciplinary collaboration between microbiologists and clinicians are critical to guiding effective antimicrobial therapy and preventing neonatal and adult GBS infections.