Perinatal group B streptococcal colonization and infection

Allardice, James G.; Baskett, Thomas F.; Seshia, Molly; Bowman, Natalie M.; Malazdrewicz, R.

doi:10.1016/s0002-9378(16)32429-2

Cited by 116 publications

(59 citation statements)

References 11 publications

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“…Yow et al [14], Kubota [23] and others [15,25] performed only vaginal or cervicovaginal swabs and found prevalences between 6% and 14.2%, whereas rectovaginal cultures done in several other studies [3,8,16,21,24,26] revealed higher rates between 19.4% and 31%, similar to the 21% found in our study. Since vaginal and in particular rectal flora contains numerous micro-organisms, the use of selective enrichment broth is recommended to maximise the isolation of GBS and to avoid the overgrowth of other organisms.…”

Section: Commentsupporting

confidence: 87%

“…In previous studies, GBS carriage prevalences between 1.6% and 30.4% have been described [2][3][4][5]7,8,[13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The differences in these prevalences can probably be explained by the different gestational ages at culturing, differences in culture site and in the use of different culture techniques.…”

Section: Commentmentioning

confidence: 99%

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Prevalence of colonisation with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands

Berg

Sprij

Oostvogel³

et al. 2006

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: This study was performed to determine the prevalence of GBS and to identify GBS colonisation risk factors in a multicultural population of pregnant women in The Netherlands. We calculated predictive values of cultures in pregnancy for intrapartum GBS carriage. Study design: From a total of 1702 women visiting several antenatal outpatient departments, rectovaginal swabs were collected at 35-37 weeks' gestation. In 761 women swabs were repeated at time of delivery. Carriage of GBS late in third trimester and at time of delivery was analysed in relation to age, parity, ethnicity and socio-economic status. Results: Twenty-one percent was GBS carrier late in pregnancy. Compared to Europeans, African women were at a higher risk (29%, RR 1.4, CI 1.1-1.7) and Asian women were at lower risk (13%, RR 0.6, CI 0.4-0.8) for GBS carriage. No differences in colonisation were found between women with respect to age, parity or socio-economic background. Positive predictive value of GBS carriage at 35-37 weeks' gestation for carriage at time of parturition was 79% and negative predictive value was 93%. Conclusions: It was not possible to identify a group of pregnant women at high risk for GBS colonisation. Predictive values of antenatal genital group B streptococci cultures at 35-37 weeks' gestation for intrapartum GBS carriage are lower than previously reported. # 2005 Published by Elsevier Ireland Ltd.

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Section: Commentsupporting

confidence: 87%

Section: Commentmentioning

confidence: 99%

Prevalence of colonisation with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands

Berg

Sprij

Oostvogel³

et al. 2006

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Group B streptococci (GBS) are one of the leading causes of neonatal and maternal infectious complications [1,2]. Neonatal infection can result in neonatal death or severe morbidity, such as septicemia, pneumonia, or meningitis.…”

Section: Introductionmentioning

confidence: 99%

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

2013

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Group B streptococci (GBS) are a leading cause of infectious neonatal morbidity and mortality. Timely and accurate identification of colonized pregnant women is imperative to implement intrapartum antibioprophylaxis (IAP) to reduce the risk of early neonatal sepsis. Current guidelines recommend screening for GBS carriage with vaginal-rectal cultures. However, cultures require 24-72 h, thus precluding their use for intrapartum screening and these are only performed at 35-37 weeks gestation. New rapid molecular-based tests can detect GBS within hours. They have the potential to be used intrapartum and to allow for selective IAP in women carrying GBS. An advantage is that they can sometimes be performed by non-laboratory staff in the labor suite, thus avoiding delays in sample transfers to the microbiology laboratory. Another possible use of molecular-based assays is for the diagnosis of neonatal sepsis, where tests with a short turnaround time and high sensitivity and specificity are crucial. In this situation, the detection of microorganisms once antibiotic therapy has already been started is important, as treatment is started immediately once sepsis is suspected without waiting for microbiological confirmation. In this article, we discuss the state-of-the-art molecular-based tests available for GBS screening during pregnancy, as well as their implications for IAP for the diagnosis and prevention of neonatal sepsis.

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“…Colonization occurs in 15 to 40% of pregnant women (1,2,6,8,15,45), contributing to a neonatal infection rate of 0.73 per 1,000 live births (13). Since studies have shown that intrapartum prophylaxis of colonized mothers can significantly reduce the rate of vertical transmission of the organism (7,23; for a review, see reference 37), current Centers for Disease Control and Prevention (CDC) recommendations suggest that all pregnant women be screened for vaginal and rectal S. agalactiae colonization at 35 to 37 weeks of gestation (10).…”

mentioning

confidence: 99%

Comparison of Carrot Broth- and Selective Todd-Hewitt Broth-Enhanced PCR Protocols for Real-Time Detection of Streptococcus agalactiae in Prenatal Vaginal/Anorectal Specimens

et al. 2008

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The reporting of accurate Streptococcus agalactiae screening results in a short time frame is of tremendous clinical benefit. A total of 203 consecutive primary vaginal/anorectal specimens were cultured in selective Todd-Hewitt broth (LIM broth) and with the StrepB carrot broth kit (carrot broth). One-day broth cultures were subjected to both centrifugation and clarification of a 500-l aliquot prior to sample lysis (protocol A) and direct lysis of a 50-l aliquot (protocol B). The lysates were subsequently analyzed by the BD GeneOhm StrepB assay. The results were compared to the carrot broth culture results derived from visualization of pigment on day 1 or from a subculture of carrot broth. Thirty-four carrot broth cultures (16.7%) generated diagnostic pigment following overnight incubation; an additional 26 (12.8%) were positive for S. agalactiae upon subculture. Carrot broth-enhanced PCR by the use of either protocol A or protocol B trended toward a higher rate of positive results (33.0%) than the rate observed by either the LIM broth-enhanced PCR (30.5%) or full carrot broth culture analysis (29.6%). In the context of the result on day 1, both carrot broth-and LIM broth-enhanced PCRs generated more true-positive results (P < 0.001) than carrot broth culture visualization. The predictive values for both protocols of carrot broth-or LIM brothenhanced PCR were >95.4%. Whereas protocol A resolved the results for 99.8% of the specimens in the evaluation upon initial testing, a 5.7% initial unresolved rate and a 1.5% final unresolved rate were determined by the use of protocol B. The use of carrot broth within a rapid and highly accurate molecular reflex testing algorithm can limit follow-up testing to cultures without evidence of pigmentation.

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Perinatal group B streptococcal colonization and infection

Cited by 116 publications

References 11 publications

Prevalence of colonisation with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands

Prevalence of colonisation with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

Comparison of Carrot Broth- and Selective Todd-Hewitt Broth-Enhanced PCR Protocols for Real-Time Detection of Streptococcus agalactiae in Prenatal Vaginal/Anorectal Specimens

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