1887

Abstract

The CDC recommends antenatal screening of vaginal/rectal samples for at 35–37 weeks' gestation, with intra-partum antibiotic prophylaxis for positive cases. We tested a modified use of the Cepheid Xpert GBS real-time PCR kit on enrichment cultures from 554 vaginal/rectal swabs compared to the current subculturing gold standard method. Swabs were inoculated on polymyxin nalidixic acid agar plates, and Todd–Hewitt enrichment broth cultures were examined daily for growth. Todd–Hewitt broth culture was also used for Xpert GBS. There was 92.06 % agreement between the subculture and PCR methods. Sensitivity of Xpert GBS was 100 %, specificity was 89.40 %, positive predictive value was 75.96 % and negative predictive value was 100 %. Colonization incidence was higher with younger (≤24 years) or older (≥35 years) maternal age. Modified use of the Cepheid Xpert GBS would assist rapid diagnosis of colonization and facilitate timely and appropriate assignment to intra-partum antibiotic prophylaxis.

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2017-10-01
2024-03-29
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References

  1. Melin P. Neonatal group B streptococcal disease: from pathogenesis to preventive strategies. Clin Microbiol Infect 2011; 17:1294–1303 [View Article][PubMed]
    [Google Scholar]
  2. Verani JR, Mcgee L, Schrag SJ. Division of bacterial diseases, national center for immunization and respiratory diseases, centers for disease control, and prevention. Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR 2010; 59:1–36
    [Google Scholar]
  3. di Renzo GC, Melin P, Berardi A, Blennow M, Carbonell-Estrany X et al. Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference. J Matern Fetal Neonatal Med 2015; 28:766–782 [View Article][PubMed]
    [Google Scholar]
  4. Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L et al. Prevalence of maternal group B streptococcal colonisation in European countries. Acta Obstet Gynecol Scand 2008; 87:260–271 [View Article][PubMed]
    [Google Scholar]
  5. Rivera L, Sáez-Llorens X, Feris-Iglesias J, Ip M, Saha S et al. Incidence and serotype distribution of invasive group B streptococcal disease in young infants: a multi-country observational study. BMC Pediatr 2015; 15:143 [View Article][PubMed]
    [Google Scholar]
  6. Edmond KM, Kortsalioudaki C, Scott S, Schrag SJ, Zaidi AK et al. Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. Lancet 2012; 379:547–556 [View Article][PubMed]
    [Google Scholar]
  7. Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep 2002; 51:1–22[PubMed]
    [Google Scholar]
  8. El Helali N, Nguyen JC, Ly A, Giovangrandi Y, Trinquart L. Diagnostic accuracy of a rapid real-time polymerase chain reaction assay for universal intrapartum group B streptococcus screening. Clin Infect Dis 2009; 49:417–423 [View Article][PubMed]
    [Google Scholar]
  9. Oddie S, Embleton ND. Risk factors for early onset neonatal group B streptococcal sepsis: case-control study. BMJ 2002; 325:308 [View Article][PubMed]
    [Google Scholar]
  10. Hansen SM, Uldbjerg N, Kilian M, Sørensen UB. Dynamics of Streptococcus agalactiae colonization in women during and after pregnancy and in their infants. J Clin Microbiol 2004; 42:83–89 [View Article][PubMed]
    [Google Scholar]
  11. de Tejada BM, Pfister RE, Renzi G, François P, Irion O et al. Intrapartum group B streptococcus detection by rapid polymerase chain reaction assay for the prevention of neonatal sepsis. Clin Microbiol Infect 2011; 17:1786–1791 [View Article][PubMed]
    [Google Scholar]
  12. Young BC, Dodge LE, Gupta M, Rhee JS, Hacker MR. Evaluation of a rapid, real-time intrapartum group B streptococcus assay. Am J Obstet Gynecol 2011; 205:372.e1–372.e6 [View Article]
    [Google Scholar]
  13. Abdelazim IA. Intrapartum polymerase chain reaction for detection of group B streptococcus colonisation. Aust N Z J Obstet Gynaecol 2013; 53:236–242 [View Article][PubMed]
    [Google Scholar]
  14. Bourgeois-Nicolaos N, Cordier AG, Guillet-Caruba C, Casanova F, Benachi A et al. Evaluation of the cepheid xpert GBS assay for rapid detection of group B Streptococci in amniotic fluids from pregnant women with premature rupture of membranes. J Clin Microbiol 2013; 51:1305–1306 [View Article][PubMed]
    [Google Scholar]
  15. Håkansson S, Källén K, Bullarbo M, Holmgren , Bremme K et al. Real-time PCR-assay in the delivery suite for determination of group B streptococcal colonization in a setting with risk-based antibiotic prophylaxis. J Matern Fetal Neonatal Med 2014; 27:328–332 [View Article][PubMed]
    [Google Scholar]
  16. Mueller M, Henle A, Droz S, Kind AB, Rohner S et al. Intrapartum detection of group B streptococci colonization by rapid PCR-test on labor ward. Eur J Obstet Gynecol Reprod Biol 2014; 176:137–141 [View Article][PubMed]
    [Google Scholar]
  17. Tanaka K, Iwashita M, Matsushima M, Wachi Y, Izawa T et al. Intrapartum group B Streptococcus screening using real-time polymerase chain reaction in Japanese population. J Matern Fetal Neonatal Med 2016; 29:130–134 [View Article][PubMed]
    [Google Scholar]
  18. Daniels JP, Gray J, Pattison HM, Gray R, Hills RK et al. Intrapartum tests for group B streptococcus: accuracy and acceptability of screening. BJOG 2011; 118:257–265 [View Article][PubMed]
    [Google Scholar]
  19. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33:159–174 [View Article][PubMed]
    [Google Scholar]
  20. Altman DG. Practical Statistics for Medical Research, 2nd ed. London: Chapman and Hall; 2010
    [Google Scholar]
  21. Buchan BW, Faron ML, Fuller D, Davis TE, Mayne D et al. Multicenter clinical evaluation of the Xpert GBS LB assay for detection of group B Streptococcus in prenatal screening specimens. J Clin Microbiol 2015; 53:443–448 [View Article][PubMed]
    [Google Scholar]
  22. Block T, Munson E, Culver A, Vaughan K, Hryciuk JE. Comparison of carrot broth- and selective todd-hewitt broth-enhanced PCR protocols for real-time detection of Streptococcus agalactiae in prenatal vaginal/anorectal specimens. J Clin Microbiol 2008; 46:3615–3620 [View Article][PubMed]
    [Google Scholar]
  23. Munson E, Napierala M, Munson KL, Culver A, Hryciuk JE. Temporal characterization of carrot broth-enhanced real-time PCR as an alternative means for rapid detection of Streptococcus agalactiae from prenatal anorectal and vaginal screenings. J Clin Microbiol 2010; 48:4495–4500 [View Article][PubMed]
    [Google Scholar]
  24. Zamzami TY, Marzouki AM, Nasrat HA. Prevalence rate of group B streptococcal colonization among women in labor at King Abdul-Aziz University Hospital. Arch Gynecol Obstet 2011; 284:677–679 [View Article][PubMed]
    [Google Scholar]
  25. Al-Kadri HM, Bamuhair SS, Johani SM, Al-Buriki NA, Tamim HM. Maternal and neonatal risk factors for early-onset group B streptococcal disease: a case control study. Int J Womens Health 2013; 5:729–735 [View Article][PubMed]
    [Google Scholar]
  26. Ahmad S. Asymptomatic group B streptococcal bacteriuria among pregnant women in Saudi Arabia. Br J Biomed Sci 2015; 72:135–139 [View Article][PubMed]
    [Google Scholar]
  27. Javanmanesh F, Eshraghi N. Prevalence of positive recto-vaginal culture for Group B streptococcus in pregnant women at 35-37 weeks of gestation. Med J Islamic Rep Iran 2013; 27:7–11
    [Google Scholar]
  28. Terry RR, Kelly FW, Gauzer C, Jeitler M. Risk factors for maternal colonization with group B beta-hemolytic streptococci. J Am Osteopath Assoc 1999; 99:571–573 [View Article][PubMed]
    [Google Scholar]
  29. Kim EJ, Oh KY, Kim MY, Seo YS, Shin J-H et al. Risk factors for group B Streptococcus colonization among pregnant women in Korea. Epidemiol Health 2011; 33:e20110010 [View Article]
    [Google Scholar]
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