Evaluation of a rapid, real-time intrapartum group B streptococcus assay

Young, Brett C.; Dodge, Laura E.; Gupta, Munish; Rhee, Jongeun; Hacker, Michele R.

doi:10.1016/j.ajog.2011.06.087

Cited by 41 publications

(43 citation statements)

References 14 publications

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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%

“…However the expected predictive values were too optimistic. In studies evaluating antenatal culture to predict intrapartum status for genital colonization with GBS, reported sensitivities range from 51% to 87%, specificities from 93.7% to 97.1%, positive and negative predictive values from 60.6% to 87% and from 88% to 96% [77,[79][80][81][82][83][84][85][86][87].…”

Section: Timing Of Screeningmentioning

confidence: 99%

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Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

148

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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Section: Non-culture Methods For Intrapartum Specimen Processingmentioning

confidence: 99%

Section: Timing Of Screeningmentioning

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

148

135

View full text Add to dashboard Cite

show abstract

“…Similar limitations have been noted with nucleic acid amplification techniques (i.e., polymerase chain reaction) in diagnosing colonization of GBS [16–19]. While initial reports found polymerase chain reaction to be less promising than anticipated; more recent studies have demonstrated good performance allowing for results in 45 minutes [20]. Yet, this newer polymerase chain reaction test still resulted in a large number (13%) of indeterminate samples which required reprocessing.…”

Section: Discussionmentioning

confidence: 83%

Accuracy of an Accelerated, Culture-Based Assay for Detection of Group BStreptococcus

Faro

Bishop

Riddle

et al. 2013

Infectious Diseases in Obstetrics and Gynecology

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Objective. To determine the validity of a novel Group B Streptococcus (GBS) diagnostic assay for the detection of GBS in antepartum patients. Study Design. Women were screened for GBS colonization at 35 to 37 weeks of gestation. Three vaginal-rectal swabs were collected per patient; two were processed by traditional culture (commercial laboratory versus in-house culture), and the third was processed by an immunoblot-based test, in which a sample is placed over an antibody-coated nitrocellulose membrane, and after a six-hour culture, bound GBS is detected with a secondary antibody. Results. 356 patients were evaluated. Commercial processing revealed a GBS prevalence rate of 85/356 (23.6%). In-house culture provided a prevalence rate of 105/356 (29.5%). When the accelerated GBS test result was compared to the in-house GBS culture, it demonstrated a sensitivity of 97.1% and a specificity of 88.4%. Interobserver reliability for the novel GBS test was 88.2%. Conclusions. The accelerated GBS test provides a high level of validity for the detection of GBS colonization in antepartum patients within 6.5 hours and demonstrates a substantial agreement between observers.

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“…PCR is more rapid than our protocol; thus, PCR is a very helpful test for detecting intrapartum GBS carriers [23,24]. In fact, the rapidity of PCR is an advantage of this method over our protocol.…”

Section: Discussionmentioning

confidence: 99%

Identification of Streptococcus agalactiae by fluorescent in situ hybridization compared to culturing and the determination of prevalence of Streptococcus agalactiae colonization among pregnant women in Bushehr, Iran

et al. 2013

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BackgroundPregnant women colonized by Streptococcus agalactiae (group B streptococci [GBS]) may transfer this microorganism to their newborns. S. agalactiae is an important cause of pneumonia, sepsis, and meningitis in newborns. Fluorescent in situ hybridization (FISH) is considered as a method of identification in the field of diagnostic microbiology. In this paper, we have designed a study to compare the DNA FISH after 7 h Lim broth enrichment and culturing for the identification of S. agalactiae and to determine the prevalence of vaginal colonization by S. agalactiae among pregnant women in Bushehr, Iran.MethodsVaginal swab specimens were obtained from 285 pregnant women at 35 weeks or more than 35 weeks of gestation. The specimens were inoculated into Lim broth. In order to evaluate the sensitivity and specificity of GBS DNA FISH after 7 h Lim broth enrichment, the specimens were tested using both FISH and conventional culture methods. In addition, the prevalence of GBS colonization was determined.ResultsBased on the results of this study, both the sensitivity and specificity of FISH were 100%. S. agalactiae was detected by both culture and FISH in 27 of the 285 pregnant women. Thus, the prevalence of GBS colonization was 9.5%.ConclusionsSince short-term (7 h) Lim broth enrichment followed by FISH using oligonucleotide probes showed a high sensitivity and specificity, this protocol is therefore a highly accurate and relatively rapid method for the detection of S. agalactiae. Our analysis suggests that the use of DNA FISH to screen for S. agalactiae colonization in pregnant women may be considered in the absence of GBS culture availability.

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Evaluation of a rapid, real-time intrapartum group B streptococcus assay

Cited by 41 publications

References 14 publications

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Accuracy of an Accelerated, Culture-Based Assay for Detection of Group BStreptococcus

Identification of Streptococcus agalactiae by fluorescent in situ hybridization compared to culturing and the determination of prevalence of Streptococcus agalactiae colonization among pregnant women in Bushehr, Iran

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