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The first expansion of the Tn 916-family transposons came with the description of Tn 5382, which is an approximately30 kb element that encodes the VanB glycopeptide-resistance operon and has substantial homology with the Tn 916 integrase and excisase genes ().
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In the absence of GBS urinary tract infection, antimicrobial agents should not be used before the intrapartum period to eradicate GBS genitorectal colonization, because such treatment is not effective in eliminating carriage or preventing neonatal disease and can cause adverse consequences (DI).
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BACTERIOSTATIC ANTIBIOTICS: Chloramphenicol, erythromycins, sulfonamides, or tetracyclines may interfere with the bactericidal effect of penicillins.
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States are encouraged to monitor incidence of GBS disease, to promote activities that enhance perinatal GBS disease prevention and education, and to assess progress toward national objectives for disease reduction, such as objectives for Healthy People 2010 ( 230) and the forthcoming Healthy People 2020 ( 263).
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Indications for intrapartum chemoprophylaxis include maternal antenatal GBS bacteriuria in any concentration in the current pregnancy, previous delivery of an infant with GBS disease, and positive maternal GBS cultures at 35 to 37 weeks of gestation ().
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