Comparison of BD GeneOhm real-time polymerase chain reaction with chromogenic and conventional culture methods for detection of group B Streptococcus in clinical samples

Smith, D D; Perry, John D.; Laine, Larissa; Galloway, A.; Gould, F.K.

doi:10.1016/j.diagmicrobio.2008.03.007

Cited by 18 publications

(19 citation statements)

References 7 publications

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“…These data appear to conflict with the direct swab PCR sensitivity value of 59% previously reported by our group in a small study set (4) and the 56% value presented in this report (sensitivity data from our laboratory did not differ significantly between studies [P ϭ 0.77]). In addition, a 77% sensitivity of the BD GeneOhm StrepB assay was reported by Smith et al (33).…”

Section: Discussionmentioning

confidence: 99%

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Temporal Characterization of Carrot Broth-Enhanced Real-Time PCR as an Alternative Means for Rapid Detection of Streptococcus agalactiae from Prenatal Anorectal and Vaginal Screenings

et al. 2010

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Analysis of overnight carrot broth culture using the BD GeneOhm StrepB assay (carrot broth-enhanced PCR) yields increased sensitivity compared to that of carrot broth culture alone for the detection of Streptococcus agalactiae. We investigated the prospect of reducing the carrot broth incubation time prior to PCR performance. In vitro experimentation demonstrated that carrot broth-enhanced PCR nominally detected 10 CFU S. agalactiae after 4 h of carrot broth incubation with competitive flora. Detection rates improved with inocula of 100 and 1,000 CFU S. agalactiae, with the majority of these aliquots demonstrating detection after 2 h of carrot broth incubation. Carrot broth was prospectively inoculated with clinical vaginal/anorectal swabs, with 500-l aliquots collected. Early aliquots from 227 specimens were subjected to carrot broth-enhanced PCR (early-aliquot carrot broth-enhanced PCR) in instances of subsequent positive carrot broth culture or positive overnight clinical carrot broth-enhanced PCR. The S. agalactiae detection rate by early-aliquot carrot broth-enhanced PCR (66.1%) exceeded that observed for 227 remnant swabs retrospectively tested by direct swab PCR (56.4%; P ‫؍‬ 0.03). Early-aliquot carrot broth-enhanced PCR detection rate differences were most pronounced in aliquots from 83 carrot broth aliquots collected after 6 h (84.3%) compared to detection rates from either direct swab PCR of these samples (51.8%; P < 0.0002) or early-aliquot carrot broth-enhanced PCR of 144 carrot broth aliquots collected after fewer than 6 h of incubation (55.6%; P < 0.0002). Enhanced sensitivity of early-aliquot carrot broth-enhanced PCR versus direct swab PCR suggests that this assay could serve as a surrogate rapid detection method facilitating the prevention of group B streptococcal disease.Streptococcus agalactiae (beta-hemolytic Streptococcus group B) can impart significant morbidity and mortality to the neonatal demographic (2). Subsequent to evidence that intrapartum antimicrobial chemoprophylaxis can prevent neonatal S. agalactiae colonization, sepsis, and mortality (21), the Centers for Disease Control and Prevention (CDC) published recommendations in 1996 (9) promoting both maternal risk-based strategies and microbiological surveillance toward the goal of identifying candidates for chemoprophylactic intervention. A 65% reduction in early-onset group B streptococcal disease was realized from 1993 to 1998 (29). Schrag et al. (28) subsequently reported that microbiological screening-derived data outperformed risk-based strategies in identifying these at-risk mothers. As a result, revised CDC guidelines published in 2002 (10) advocate universal late-antenatal screening at 35 to 37 weeks of gestation for S. agalactiae colonization.Van Dyke et al. (35) recently reported results from a 2-year, 10-state surveillance project assessing invasive group B streptococcal disease. While the percentage of women being screened for S. agalactiae increased from 48.1% in 1999 to 85.0% in 2003 to 2004, the overall incidence of ...

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Section: Discussionmentioning

confidence: 99%

“…Goodrich and Miller (19) determined sensitivity of the StrepB assay at 92.5% for 4-h LIM broth cultures that were subsequently held at 4°C prior to nucleic acid extraction. Finally, a component of the combined reference standard utilized by Smith et al (33) was a selective solid medium that outperformed a reference agar medium.…”

Section: Discussionmentioning

confidence: 99%

Temporal Characterization of Carrot Broth-Enhanced Real-Time PCR as an Alternative Means for Rapid Detection of Streptococcus agalactiae from Prenatal Anorectal and Vaginal Screenings

et al. 2010

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“…Rapid real-time PCR assays for GBS detection have been further developed and their performances have been evaluated these last years as summed up in Table 2. When compared to enriched GBS cultures, sensitivity and specificity for PCR tests range from 62.5%-100% and 84.6-100% while PPV and NPV range from 65-100% and 92.3-100% [80,82,[84][85][86][103][104][105][106][107][108][109][110][111]. Today, real-time PCRbased tests (NAAT) can equal or surpass the sensitivity of antenatal culture at 35-37 weeks' gestation and compare favorably with reference to bacterial culture performed at presentation for delivery taken as gold standard for the detection of GBS colonization [80,82,101,102,112].…”

Section: Non-culture Methods For Intrapartum Specimen Processingmentioning

confidence: 99%

“…Others like the BD GeneOhm StrepB Assay, even when they present good analytical performances [108], cannot be used as a bedside testing kit but must be run by skilled operators in a laboratory setting and requires several operating steps. Unlike the others, the XpertÔ GBS assay is performed on a platform (GeneXpert Dx System) where sample preparation, amplification and detection steps are fully automated and completely integrated.…”

Section: Non-culture Methods For Intrapartum Specimen Processingmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

153

135

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Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

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“…Current guidelines for prenatal GBS screening recommend obtaining a vaginal-rectal swab and the use of selective broth enrichment, to maximize sensitivity (1,7). Few studies have examined the use of chromogenic media for the detection of GBS from screening specimens (6,8,9). In this evaluation, although StrepB Select medium demonstrated excellent sensitivity for the detection of GBS, there are a few limitations that need to be mentioned.…”

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confidence: 99%

Evaluation of a New Chromogenic Medium (StrepB Select ) for Detection of Group B Streptococcus from Vaginal-Rectal Specimens

et al. 2010

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We compared StrepB Select medium (Select) after enrichment with conventional culture for the detection of Group B Streptococcus (GBS). Postenrichment sensitivities of Select and conventional culture were 98.8% and 92.2%, respectively (P < 0.05). Select was superior for detection of GBS from vaginal-rectal specimens. Growth of non-GBS colonies required additional work to exclude the presence of GBS, especially after 48 h of incubation. Incubation of Select beyond 24 h did not significantly increase the yield of GBS.As group B Streptococcus (GBS) remains a significant cause of neonatal morbidity and mortality, antenatal screening for GBS at 35 to 37 weeks of gestation is recommended to determine whether antimicrobial prophylaxis is warranted (4, 7). The use of newer, chromogenic media may improve the yield of GBS, while reducing labor and turnaround time (5). We evaluated a new chromogenic medium, StrepB Select (Select; Bio-Rad Laboratories, Marnes-la-Coquette, France), a selective medium for the detection and presumptive identification of GBS in vaginal and vaginal-rectal specimens (9). We compared the recovery of GBS from StrepB Select with that from conventional culture on colistin-nalidixic acid agar with 5% sheep blood (CNA; Oxoid, Nepean, Ontario, Canada) with and without broth enrichment using Streptococcus selective broth (SSB; Bio-Media Ltd., Woodbridge, Ontario, Canada).From September to November 2008, a total of 1,025 specimens from 992 patients were submitted for GBS screening. These swabs were directly inoculated onto CNA plates and then placed into enrichment broth (SSB). After 24 h of incubation, the direct CNA plate was examined for the presence of colonies suggestive of GBS. If direct culture on CNA did not yield GBS, the SSB was subcultured onto CNA and incubated for 24 h. All broths were subcultured onto StrepB Select and incubated for up to 48 h at 37°C in ambient air, per the manufacturer's recommendations. Colonies suggestive of GBS, with a turquoise blue color on Select and gray colonies with or without hemolysis on CNA, were worked up by separate, experienced technologists blinded to each other's work. Identification of GBS was performed using conventional tests, including those with catalase, Gram stain, and Lancefield grouping antisera by using the PathoDx latex agglutination kit (Remel, Inc., Lenexa, KS). PCR testing for the cfb gene encoding the Christie-Atkins-Munch-Petersen (CAMP) factor (3), directly from the SSB enrichment broth, was used as the gold standard. A true positive was defined as growth of GBS on either medium.Of the 1,025 specimens tested, a total of 243 (23.7%) yielded GBS, and the same 243 specimens were also positive by PCR for the cfb gene. Direct culture onto CNA yielded GBS from 201 samples (82.7%) ( Table 1). SSB enrichment with CNA subculture at 24 h detected an additional 23 isolates (224/243 samples; 92.2%), while SSB enrichment with Select subculture detected GBS in 240 of 243 samples, for a sensitivity of 98.8% (P Ͻ 0.0001). There were no specimens that yield...

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Comparison of BD GeneOhm real-time polymerase chain reaction with chromogenic and conventional culture methods for detection of group B Streptococcus in clinical samples

Cited by 18 publications

References 7 publications

Temporal Characterization of Carrot Broth-Enhanced Real-Time PCR as an Alternative Means for Rapid Detection of Streptococcus agalactiae from Prenatal Anorectal and Vaginal Screenings

Temporal Characterization of Carrot Broth-Enhanced Real-Time PCR as an Alternative Means for Rapid Detection of Streptococcus agalactiae from Prenatal Anorectal and Vaginal Screenings

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Evaluation of a New Chromogenic Medium (StrepB Select ) for Detection of Group B Streptococcus from Vaginal-Rectal Specimens

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