Diagnostic accuracy of polymerase chain reaction for intrapartum detection of group B streptococcus colonization

Helmig, Rikke Bek; Gertsen, Jan Berg

doi:10.1111/aogs.13169

Cited by 18 publications

(16 citation statements)

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“…A total of 89 samples that tested positive by culture (regardless of whether they are positive or not by any of the PCRs) and/or positive by both PCR techniques (although negative by culture) were considered true positives, giving an overall detection rate of 27.81%. The GBS detection rated reported in this study was slightly higher compared to previous studies in Spain [ 17 , 21 ], but in agreement with the SGB prevalence reported in different studies performed in Europe [ 7 , 34 , 35 ]. According to previous studies, the detection rate for GBS ranged between 10 and 35% [ 4 , 7 , 22 , 36 ].…”

Section: Discussionsupporting

confidence: 92%

Comparison of qPCR and culture methods for group B Streptococcus colonization detection in pregnant women: evaluation of a new qPCR assay

et al. 2018

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BackgroundStreptococcus Group B (GBS) colonization in pregnant women is the most important risk factor for newborn disease due to vertical transmission during delivery. GBS colonization during pregnancy has been implicated as a leading cause of perinatal infections. Traditionally, pregnant women are screened for GBS between 35 and 37 weeks of gestation. However, antenatal culture-based screening yields no information on GBS colonization status and offers low predictive value for GBS colonization at delivery. Numerous assays have been evaluated for GBS screening in an attempt to validate a fast and efficient method. The aim of this study was to compare bacteria isolation by culture and two qPCR techniques, targeting sip and cfb genes, respectively, for detecting colonizing GBS.MethodsCultures – the gold-standard technique, a previous qPCR technique targeting the sip gene, and a new proposed qPCR assay targeting the cfb gene were evaluated as diagnostic tools on 320 samples.ResultsConsidering cultures as the gold standard, the evaluated qPCR method detected 75 out of 78 samples, representing a sensitivity of 93.58% (95% confidence interval (CI), 90.89–96.27) and specificity of 94.62% (95% CI, 91.78–97.46). However, an additional analysis was performed for true positives that included not only samples showing positives by culture but samples showing positive for both qPCR assays. The sensitivity and specificity were recalculated including these discrepant samples and a total of 89 samples were considered as positive, giving a prevalence of 27.81%. With this new analysis, the qPCR targeting the cfb gene showed a sensitivity of 95.5% (95% CI, 88.65–98.59) and specificity of 99.13% (95% CI, 96.69–99.97).ConclusionsThe new qPCR method is a sensitive and specific assay for detecting GBS colonization and represents a valuable tool for identifying candidates for intrapartum antibiotic prophylaxis. Cultures should be retained as the reference and the routine technique because of its specificity and cost analysis ratio, but it would be convenient to introduce PCR techniques to check negative culture samples or when an urgent detection is required to reduce risk of infection among infants.

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Section: Discussionsupporting

confidence: 92%

Comparison of qPCR and culture methods for group B Streptococcus colonization detection in pregnant women: evaluation of a new qPCR assay

et al. 2018

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“…Although the revised CDC guidelines [1] recommend universal culture-based GBS screening between 35 and 37 weeks of pregnancy, the use of molecular methods as an additional rapid method of detection is encouraged. In concordance to our data, increased GBS detection rates by PCR assays compared to culture have been previously reported [15,23] with comparable results [5,6,8,24] or with lower colonization rates than the ones observed in this study [25]. However, previous data showed comparable performance of PCR method to culture [14].…”

Section: Discussionsupporting

confidence: 93%

Antenatal group B streptococcus detection in pregnant women: culture or PCR?

Gerolymatos

Karlovasiti

Sianou

et al. 2018

J Infect Dev Ctries

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Introduction: Group B streptococcus (GBS) is an important cause of neonatal infections. Maternal GBS colonization screening and intrapartum antimicrobial prophylaxis of colonized women can prevent neonatal diseases. The aim of this study was to assess the prevalence of GBS colonization in pregnant and non-pregnant women and to compare the performance of a polymerase chain reaction (PCR) assay with the established as gold standard technique, culture method, used for the detection of this microorganism. Methodology: Vaginal and rectal samples collected from 857 pregnant and 370 non-pregnant women were examined through cultures, while the samples collected from 452 pregnant women between 35 and 37 weeks of gestation were assayed by culture and PCR method targeting the cfb gene. Results: GBS colonization was present in both pregnant and non-pregnant women. The colonization rate was similar in non-pregnant and first trimester pregnant women and then increased from first to the third trimester of pregnancy. GBS cultures for vaginal and rectal samples were positive in 13.2% and 14.3% in non-pregnant women, while in pregnant women 13.2% and 13.7% in the first trimester, and 15.0% and 16.5% in the second trimester, respectively. In third trimester pregnant women, compared to culture method, PCR identified a significantly increased number of GBS positive vaginal (18.4% vs 22.6%, p = 0.0006) and rectal (18.1% vs 21.2%, p = 0.01) samples. Conclusions: GBS colonization rate was higher in the third trimester. PCR proved to be a rapid and useful GBS screening method allowing a shorter detection time, while identifying more colonized women than culture.

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“…It is reported that the antenatal microbiological screening test has the sensitivity of about 60% and a relatively low specificity [16,[19][20][21]. Our studies confirmed a high sensitivity of intrapartum PCR assay when compared to antenatal culture, which is consistent with other studies [22][23][24][25]. This result is important because as it has been shown in Young et al report, majority of newborns with sepsis was born from women with GBS negative antenatal screening test and subsequently without the IAP [18].…”

Section: Discussionsupporting

confidence: 92%

Intrapartum PCR assay is a fast and efficient screening method for Group B Streptococcus detection in pregnancy

et al. 2020

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Objectives: The aim of the study is to verify the usefulness of a real-time polymerase chain reaction versus the culture for ante-and intrapartum group B Streptococcus maternal colonization (GBS) and prevalence of discordance during the period between an antepartum screening and delivery. Material and methods: The study involved 106 pregnant women aged 18 to 39 years. Rectovaginal samples were collected according to CDC guidelines at 35-37 weeks of gestation as well as in the first stage of labour, during physical examination and were analyzed using two independent diagnostic methods: microbiological culture with standard culture and polymerase chain reaction with real-time assay. Results: The discordance between antenatal and intrapartum GBS prevalence has been demonstrated as well as differences associated with diagnostic strategies, culture and PCR. Conclusions: Intrapartum detection of GBS colonization using culture or Real-Time PCR assay as well, regardless of antenatal screening test for GBS, is very useful in identifying women who require implementation or withdrawal from prophylactic intrapartum antibiotic therapy. Real-Time PCR is a quick efficient method for GBS screening in pregnant women, which can be even applied during labor due to its short time of analyzing and high sensitivity and specificity. The above fact may indicate the need to perform the GBS test in the intrapartum period in all pregnant GBS negative women using PCR assay as a more adequate diagnostic method as the procedure could reduce the risk of a neonatal GBS infection subsequently to a prophylactic antibiotic therapy in women with an intrapartum positive GBS.

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Diagnostic accuracy of polymerase chain reaction for intrapartum detection of group B streptococcus colonization

Abstract: The PCR test has sufficient accuracy to direct intrapartum antibiotic prophylaxis for GBS transmission during delivery.

Cited by 18 publications

References 10 publications

Comparison of qPCR and culture methods for group B Streptococcus colonization detection in pregnant women: evaluation of a new qPCR assay

Comparison of qPCR and culture methods for group B Streptococcus colonization detection in pregnant women: evaluation of a new qPCR assay

Antenatal group B streptococcus detection in pregnant women: culture or PCR?

Intrapartum PCR assay is a fast and efficient screening method for Group B Streptococcus detection in pregnancy

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