A combined enrichment/polymerase chain reaction based method for the routine screening of Streptococcus agalactiae in pregnant women

Introduction: Group B Streptococcus (GBS), a source of neonatal infection, colonizes the gastrointestinal and genitourinary tracts of pregnant women. Routine screening for maternal GBS in late pregnancy and consequent intrapartum antibiotic prophylaxis have reduced the incidence of early-onset GBS neonatal infection. The aim of this study was to evaluate the performance of PCR, compared to culture (gold standard), in GBS colonization screening of pregnant women, and to establish the prevalence of GBS colonization among this population. Methods: Vaginal introitus and perianal samples were collected from 204 pregnant women, between the 35 th and 37 th weeks of pregnancy, at the Obstetrics and Gynecology Unit of the University of Caxias do Sul General Hospital between June 2008 and September 2009. All samples were cultured after enrichment in a selective medium and then assayed by culture and PCR methods. Results: The culture and PCR methods yielded detection rates of vaginal/perianal GBS colonization of 22.5% and 26%, respectively (sensitivity 100%; specificity 95.6%; positive and negative predictive values 86.8% and 100%, respectively). A higher prevalence of GBS colonization was detected in the combined vaginal and perianal samples by both culture and PCR assay analyses. Conclusions: PCR is a faster and more efficient method for GBS screening, allowing for optimal identification of women who should receive intrapartum antibiotic prophylaxis to prevent newborn infection.

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“…Regardless, the colonization rates observed in this study (22.5% to 26%) are consistent with those detected worldwide 2,6,8,14,16,18,20 .…”

Section: Tablesupporting

confidence: 91%

“…The electrophoresis was performed according to the method of Sambrook et al [18][19][20] using 2% agarose gel. The amplification products were detected using 1:5 ratio of the amplified reaction mixture with 1μL GelRed (Nucleic Gel Stain, BioAmerica, Inc.) and visualized under ultraviolet light.…”

Section: Pcr Assaymentioning

confidence: 99%

Group B Streptococcus detection in pregnant women via culture and PCR methods

Wollheim

Sperhacke

Fontana

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…GBS colonization rates were 19.7% and 30.5% when using culture and PCR methods, respectively. In Brazil, recent studies report a prevalence ranging from 15.9% to 22.5%, when using the culture method [27][28][29], and from 26.9% to 35.9% when using the PCR method [28,29]. These rates are very similar to observed in this study.…”

Section: Discussionsupporting

confidence: 89%

Detection of Group B Streptococcus agalactiae from Anorectal and Vaginal Screening Tests

Schörner¹

2014

Clin Microbiol

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Objective:The aim of the present study was to analyze two DNA extraction methods for use in molecular GBS diagnostics and compare them to the results of culture method. Materials and methods:Two hundred vaginal samples were collected during the antenatal period, as per CDC recommendations, and atr gene polymerase chain reaction (PCR) was performed. Results:Comparison of the two DNA extraction methods demonstrated 45% concordance. Sensitivity and specificity for 5 M Guanidine DNA extraction were 100% and 86.5%, respectively. Sensitivity and specificity for the commercial DNA extraction kit were 50% and 95%, respectively. Conclusion:This study demonstrated that 5 M Guanidine DNA extraction was superior to the commercial kit, with PCR presenting a shorter turnaround time than culture. PCR could improve sensitivity and, therefore, may be a useful screening method. Sensitive GBS diagnosis allows for an effective treatment, with decreased newborn morbidity and mortality; therefore, cost-effectiveness studies are necessary to assess the feasibility of implementing PCR in routine laboratories, together with maternity ward collaboration. Schörner MA, et al., Clin Microbial 2014, 3:5 Negative Predictive Value (NPV)* (CI95%) PCR-Guanidine 0.892 (0.848-0.934) 1.000 (1.000-1.000) 0.865 (0.813-0.917) 0.645 (0.526-0.764) 1.000 (1.000-1.000) PCR-Kit 0.852 (0.801-0.902) 0.500 (0.345-0.655) 0.946 (0.910-0.983) 0.714 (0.546-0.881) 0.876 (0.824-0.997) Citation: Schörner MA, May Feuershuette OH, Scheffer MC, Senna SG, Bazzo ML (2014) Detection of Group B Streptococcus agalactiae from Anorectal and Vaginal Screening Tests. Clin Microbial 3: 169. Clinical Microbiology: Open Access

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“…One example is MB tests for detecting group B streptococci (GBS) in vaginal and/or anal canal in parturient women, with a reliable result within 2 h [32][33][34][35][36]. These tests can dramatically reduce the risk to miss women who were not screened by culture before admission, or screened too late to have the result available at the time of admission.…”

Section: Nucleic Acid Amplifications Tests and Point-of-carementioning

confidence: 99%

Role of Molecular Biology in Diagnosis and Characterization of Vulvo-Vaginitis in Clinical Practice

Donders¹,

Vitali

Netea

et al. 2017

Gynecol Obstet Invest

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The diagnosis of vulvo-vaginal complaints has always been enigmatic in obstetrics and gynecology. Patients with clear, pathognomonic symptoms end up with a proper diagnosis and treatment most of the time, but unfortunately we are now living in a world where women reach out to the Internet and readily get all information as to which disease their symptoms correspond to and also find the appropriate treatment “over-the-counter.” Because of this trend, we as specialists are increasingly confronted with patients with complex and combined conditions. At the same time, extremely sensitive and accurate diagnostic tools are now being developed at a rapid pace, allowing the physicians to diagnose vulvo-vaginal disease with a substantially increased precision. Moreover, many of these molecular biology (MB)-based tests have become so common and affordable that self-sampling and self-testing are no longer utopia. On the other hand, too much information that is too readily available and that is too affordable also encompasses pitfalls, leading to gross overtreatment and psychological burden. As experienced caregivers, we should supervise these evolutions, define their place and proper use as diagnostic tools, utilize their potential as ad hoc tools to follow-up treatment efficacy and guide how such tools can be used for responsible self-testing. In the present paper, responding to the need for appropriate, quality assured and accessible tests for vulvo-vaginitis and the huge potential delivered by the rapidly developing MB methods, we recommend the need for a broad and regular discussion forum, composed of both clinical and technical experts and opinion makers, in order to match the needs with the huge opportunities and ideally combine the initiatives and forces into the same direction. This forum should then translate conceived strategies into regularly updated, evidence-based national and international guidelines.

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A combined enrichment/polymerase chain reaction based method for the routine screening of Streptococcus agalactiae in pregnant women

Cited by 12 publications

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Group B Streptococcus detection in pregnant women via culture and PCR methods

Group B Streptococcus detection in pregnant women via culture and PCR methods

Detection of Group B Streptococcus agalactiae from Anorectal and Vaginal Screening Tests

Role of Molecular Biology in Diagnosis and Characterization of Vulvo-Vaginitis in Clinical Practice

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