Streptococcus agalactiae (group B streptococcus) is a significant cause of perinatal and neonatal infections in the United States. Colonization occurs in 10 to 30% of pregnant women (1, 7, 10) and is responsible for 1.8 neonatal infections per 1,000 live births per year (8). Neonatal colonization with group B streptococcus occurs in about 11% of babies (2). Screening of pregnant women for group B streptococcus is aimed at identifying those pregnancies at highest risk for developing maternal and neonatal diseases. The Centers for Disease Control and Prevention presently recommends culturing samples from pregnant women at 35 to 37 weeks gestation for S. agalactiae from vaginal and anorectal swabs after 18 to 24 h of growth in a selective enrichment medium, such as LIM or SBM (8). This process requires a minimum of 48 h to complete. A more rapid and sensitive method would be beneficial, especially in dealing with patients who present for delivery without any prenatal care. Although rapid detection techniques are available, none of these methods have the sensitivity needed to identify colonized women (5). Similarly, direct culture onto solid medium, such as sheep blood agar plates (SBAP), underestimates the actual incidence of rectovaginal colonization (3,4,15). Recently, new techniques have become available that may increase the sensitivity of group B streptococcus detection or decrease the turnaround time until detection. Granada agar is a differential medium that was developed to identify colonies of group B streptococci by their orange pigment production (9) while the AccuProbe S. agalactiae rRNA probe assay (GenProbe, San Diego, Calif.) was developed to detect bacterial rRNA. This study investigated the use of both Granada agar and the AccuProbe assay as potential methods for increasing the detection of S. agalactiae in pregnant women and in decreasing the turnaround time for reporting the results.Four hundred sixty-three serially collected anovaginal swab specimens were tested in parallel by three different group B streptococcus detection methods. Swabs were inoculated directly onto Granada agar (Hardy Diagnostics, Santa Maria, Calif.) and were then placed into LIM broth (Remel, Lenexa, Kans.). Granada agar was incubated anaerobically at 35°C and was examined after 24 and 48 h of incubation. S. agalactiae colonies were detected by their production of an orange pigment. Such colonies were confirmed as S. agalactiae by using the Streptex latex agglutination reagent (Murex Biotech Ltd., Dartford, England). LIM broth was incubated aerobically at 35°C for 18 to 24 h. The broth was then subcultured onto an SBAP (Remel) for detection of beta-hemolytic colonies after 24 h of additional growth on the solid medium. Beta-hemolytic colonies were again confirmed as S. agalactiae by using the Streptex latex agglutination reagent. Immediately after inoculating the SBAP, the LIM broth was thoroughly mixed by using a vortex-type mixer and a 50-l aliquot that was tested by using the AccuProbe S. agalactiae rRNA probe assay (Gen...