Poster Presentation Lancefield International Symposium for Streptococci and Streptococcal Diseases 2025

Multidrug resistance in group B streptococcus causing urinary tract infection exposes an erythromycin-driven protective effect against oxidative stress (#258)

Kelvin Goh 1 , Devika Desai 1 , Matthew Sullivan 2 , Ellen Copeman 2 , Glen Ulett 1
  1. Griffith University, Gold Coast, QLD, Australia
  2. University of East Anglia, Norwich, UK

Multidrug resistance has been reported in group B streptococcus (GBS) from various

origins but rates among urinary tract infection (UTI) isolates are largely unknown.

Erythromycin, a second-line antibiotic for GBS for which high rates of resistance have

been reported supports the resistance of Staphylococcus to

oxidative stress. Here, we sought to survey multidrug resistant (MDR) GBS from UTI and to investigate

the affect of erythromycin exposure on the bacteria’s ability to resist oxidative stress. We

determined the antibacterial activity of 18 antibiotics against 292 GBS UTI isolates by

disk diffusion; and used in vitro growth assays of MDR GBS exposed to

erythromycin to examine relative resistance to oxidative stress, in the form of H2O2. A

high proportion of all 292 GBS isolates (33.6%) were MDR reflecting high rates of

resistance to four antibiotics: azithromycin (44.5%), clindamycin (26%), erythromycin

(36.3%), and tetracycline (81.5%); however, no resistance was detected for any other

antibiotics tested. Rates of resistance were not significantly different when analysed

according to clinical origins of (acute, recurrent UTI, asymptomatic bacteriuria). The

growth of MDR GBS was attenuated and severely inhibited by exposure to

erythromycin and H2O2, respectively. Surprisingly, exposure of MDR GBS to

erythromycin significantly relieved the severe growth inhibitory effect of H2O2

signifying a partial rescue affect of the antibiotic. The GBS isolates in this study exhibit

high levels of multidrug resistance without an association between resistance and

clinical origin. Exposure of MDR GBS to erythromycin can partially counteract the

severe growth inhibitory effect from H2O2.