Should the laboratory routinely perform antimicrobial susceptibility tests on GBS isolated from prenatal screening cultures?
No. Antimicrobial susceptibility tests are needed only for isolates from women who are penicillin-allergic and at high risk for anaphylaxis. The recommended therapy for prophylaxis in GBS-colonized pregnant women is IV penicillin; IV ampicillin is an alternative. To date, resistance to penicillin or ampicillin has not been encountered in GBS. For the penicillin-allergic patient who is NOT at high risk for anaphylaxis, IV cefazolin is suggested. NCCLS Table 2H includes a comment indicating that penicillin-susceptible streptococci can be considered susceptible to cefazolin and many other beta-lactam agents. This precludes the need for testing cefazolin against GBS. For penicillin-allergic mothers at high risk for anaphylaxis, IV clindamycin or IV erythromycin can be used, as initially recommended in the 1996 guidelines. However, the 2002 guideline stresses the importance of assessing the actual risk of anaphylaxis first, since, in contrast to the beta-lactams mentioned above, resistance
Related Questions
- Since I perform only a few simple tests in my office, do Clinical Laboratory Improvement Amendments (CLIA) regulations apply to my practice?
- Should the laboratory routinely perform antimicrobial susceptibility tests on GBS isolated from prenatal screening cultures?
- Why doesn’t the Blood Service routinely perform anti-HBc screening on all donations?
