(HealthDay News) — Laboratory-confirmed clinical group B streptococcus isolates showing vancomycin resistance have been identified, according to a letter to the editor published in the February 27 issue of the New England Journal of Medicine.
Connie Park, MD, from the Montefiore Medical Center in New York City, and colleagues reported two cases of invasive group B streptococcus infection with decreased vancomycin susceptibility without an epidemiologic link.
The researchers note that the first patient, an 82-year-old woman with diabetes, was referred to a New York City emergency department for assessment of fever and right ankle pain with swelling following an open fracture repair. Blood and wound cultures obtained at admission grew Streptococcus agalactiae with a minimum inhibitory concentration (MIC) of vancomycin of 4µg/mL. The second patient, a 48-year-old man with end-stage kidney disease undergoing hemodialysis and presenting to a New Mexico emergency room, had recently completed a course of vancomycin for group B streptococcus bacteremia from a left hip sacroiliitis. His initial blood cultures grew S. agalactiae with a MIC of 4µg/mL. The isolates, which were identified as vancomycin-non-susceptible group B streptococci, were confirmed as capsular serotype II, multilocus sequence type 22 S. agalactiae, and differed in their resistance pattern.
“These cases emphasize the importance of continued surveillance for resistant group B streptococcus,” the authors write. “Clinicians and laboratories should be encouraged to report suspected vancomycin-resistant group B streptococcus to health authorities for confirmation, since this resistance profile may be emerging.”