Sensitivity of intrapartum group B streptococcal screening and in vitro comparison of four rapid antigen tests

Adriaanse, Albert H.; Muytjens, Harry L.; Kollée, L.A.A.; Nijhuis, Jan G.; Eskes, T.K.A.B.

doi:10.1016/0028-2243(94)90148-1

Cited by 8 publications

(2 citation statements)

References 25 publications

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“…When ordinary cultures on blood agar were used, we found that 13.5% of the pregnant women in our study harbored GBS in the genital tract, which is within the range of prevalence (2 to 40%) reported by others (1,3,65). In almost two-thirds of the women in our study who had GBS cultured from the uterine cervix, GBS could also be found in the rectum.…”

Section: Discussionsupporting

confidence: 85%

Colonization in the rectum and uterine cervix with group B streptococci may induce specific antibody responses in cervical secretions of pregnant women

et al. 1996

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We have studied the relationships between genital or rectal carriage of group B streptococci (GBS) with the levels of systemic and mucosal antibodies to GBS in 200 women at about week 17 of pregnancy. Secretions from the uterine cervix were collected with absorbent cylindrical wicks for quantification of antibody levels with whole cell enzyme-linked immunosorbent assay. GBS were cultured from the cervix (with or without concomitant rectal colonization) of 13.5%, from the rectum (with or without concomitant cervical colonization) of 12%, and from both culture sites of 8.5% of the women. Serotypes Ia, II, and III were predominant. Compared with culture-negative women, the group of women colonized rectally had markedly elevated levels of both immunoglobulin A (IgA) and IgG antibodies to GBS in cervical secretions and also had a moderate but significant elevation of IgA antibodies in sera. Women colonized only in the cervix had increases of specific IgA and IgG antibodies in cervical secretions, but their serum antibody levels were not elevated. In cervical secretions, the increase in antibody levels in the groups of colonized women was most pronounced for the IgG isotype, indicating a mucosal immune response involving IgG as well as IgA. A close correlation was found among the levels of antibodies to each of the three GBS serotypes tested. Evidence for such cross-reacting antibodies to different serotypes of GBS, as well as to group A streptococci, was also obtained from absorption experiments. Altogether, our results show that undiluted secretions for antibody determination can be easily collected from the uterine cervix with absorbent wicks and demonstrate that colonization of GBS in the rectum and the uterine cervix may induce a systemic as well as a pronounced local immune response in the female genital tract. The findings may have implications for the development of a mucosal vaccine against GBS disease.

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Section: Discussionsupporting

confidence: 85%

Colonization in the rectum and uterine cervix with group B streptococci may induce specific antibody responses in cervical secretions of pregnant women

et al. 1996

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“…Moreover, as compared to antibiotic therapy, chlorhexidine disinfection would ob viate the necessity of selection. The omission of rapid GBS antigen tests would be advantageous as, so far, they lack sufficient sensitivity [21].…”

Section: Ah Adriaanse Et a I /European Journal Of Obstetrics And Gymentioning

confidence: 99%

Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Adriaanse¹,

Kollée²,

Muytjens³

et al. 1995

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: To evaluate the effect of vaginal disinfection with chlorhexidine gel during labor on vertical transmission of group B streptococcus, as a method to prevent vertical transmission and subsequent neonatal early onset group B streptococcal disease. Study Design: A prospective study with randomization of 1020 parturients to one of three groups as soon as labor started. In all parturients, anus, introitus and cervix were cultured semiquantitatively. Two groups were treated double-blindly with 10 ml of either a 0.3% chlorhexidine gel or a placebo gel, applicated around the portio and into the fomices. If labor still continued, a second application was given after 10 h. The third group received no treatment. Ear, pharynx and umbilicus of all newborns were also cultured semiquantitatively. Results: Nine hundred and eighty one women were evaluated. The overall incidence of group B strep tococcal carriership was 19.4%. Vertical transmission was 52.4% in the chlorhexidine group, 71.4% in the placebo group and 66.7% in the control group (P = 0.069). When testing the transmission rates for the chlorhexidine versus the combined placebo plus control group (69.3%), the difference was 16.9% (P ~ 0.026). Conclusion: Vaginal disinfection with a chlorhexidine gel during labor modest ly reduces group B streptococcal vertical transmission. Because the method is cheap, simple and safe, it should be considered for routine use. Our results indicate that it may reduce the incidence of early onset group B streptococcal sepsis by 2-32%.

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Accuracy of rapid antigen detection test for group B streptococci in the indigenous vaginal bacterial flora

Donders

Vereecken²,

Salembier³

et al. 1999

Archives of Gynecology and Obstetrics

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With a sensitivity of 70% the enzyme immunoassay ICONR does not appear to be suitable as a practical screening tool for detecting GBS carriage in normal or preterm laboring women. In the presence of enterococci the test performed less well, with a DOR falling by 8 to 9 fold. We presume this is due to lower specificity in vivo in the presence of enterococci, as non-specific disturbance of the lactobacillary flora did not interfere with test results.

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Sensitivity of intrapartum group B streptococcal screening and in vitro comparison of four rapid antigen tests

Cited by 8 publications

References 25 publications

Colonization in the rectum and uterine cervix with group B streptococci may induce specific antibody responses in cervical secretions of pregnant women

Colonization in the rectum and uterine cervix with group B streptococci may induce specific antibody responses in cervical secretions of pregnant women

Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Accuracy of rapid antigen detection test for group B streptococci in the indigenous vaginal bacterial flora

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