Antenatal screening for Group B Streptococcus: A diagnostic cohort study

Hiller, Janet E.; McDonald, Helen; Darbyshire, Philip; Crowther, Caroline A

doi:10.1186/1471-2393-5-12

Cited by 22 publications

(16 citation statements)

References 16 publications

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“…In a Korean study, the average delivery time for Korean pregnant women was about 5 hr [30]. In fact, because GBS carriage in pregnant women may be intermittent, a prenatal culture might be a poor predictor of maternal GBS carriage at the time of delivery [11, 27, 31]. As a feasible alternative to intrapartum culture, an intrapartum molecular test could change the current practice of prenatal screening between 35 and 37 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization

et al. 2013

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BackgroundGroup B streptococcus (GBS) infection is a leading cause of neonatal morbidity and mortality worldwide. Here, we present the analytical and diagnostic usefulness of a new real-time PCR-based assay (Xpert GBS; Cepheid, USA) for rapid and accurate prenatal GBS screening.MethodsWe enrolled 175 pregnant women who were between 35 and 39 weeks of gestation. The analytical performance of the Xpert GBS assay was first tested using a reference GBS strain. Next, to test diagnostic performance, rectovaginal swabs were obtained from pregnant women who visited the hospital for regular antenatal screening after 34 weeks of gestation. The results of the Xpert GBS assay were compared to those of standard culture for the detection of prenatal GBS colonization.ResultsWhen any positive result from Xpert GBS or culture was considered a true positive, the sensitivity of the Xpert GBS assay and culture were 91% (20/22; 95% CI [confidence interval], 72-98) and 68% (15/22; 95% CI, 47-84), respectively. The specificity of both methods was 100% (153/153; 95% CI, 97-100). The sensitivity and specificity of the Xpert GBS assay, using the culture results as a reference, were 86.7% and 95.6%, respectively. In the Xpert GBS assay, the median threshold cycle of vaginally colonized samples was significantly lower than rectally colonized samples (P<0.01).ConclusionsThe Xpert GBS assay is an accurate, rapid, easy-to-use test for the detection of maternal GBS colonization in prenatal screening that might be especially useful in clinical settings where standard culture is not feasible.

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Section: Discussionmentioning

confidence: 99%

Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization

et al. 2013

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“… Universal screening strategy that requires all pregnant women to have recto‐vaginal swabs taken for GBS culture at 35–37 weeks gestation. If taken within 5 weeks of delivery, culture results have positive and negative predictive values of 77–87% and 94–96% respectively for GBS in the birth canal during labour 20,22 . Sensitivity of culture depends upon collection technique and laboratory culture methods, which should optimally include a selective broth enrichment step 2 ().…”

Section: Prevention Of Early‐onset Neonatal Gbs Infectionmentioning

confidence: 99%

“…Between 10% and 30% of pregnant women are either intermittently or persistently colonised with GBS and are at risk of transmitting this pathogen to their newborn infant in the peri-natal period. 7,19,20 The gastrointestinal tract is the primary reservoir for GBS and usually the source of vaginal colonisation. Colonisation rates have altered little over the past three decades.…”

Section: Primary Prevention: Maternal Iapmentioning

confidence: 99%

“…If taken within 5 weeks of delivery, culture results have positive and negative predictive values of 77-87% and 94-96% respectively for GBS in the birth canal during labour. 20,22 Sensitivity of culture depends upon collection technique and laboratory culture methods, which should optimally include a selective broth enrichment step 2 (Box 1). In contrast, GBS culture results from earlier in pregnancy cannot reliably predict GBS status at delivery.…”

Section: Identifying Women At Riskmentioning

confidence: 99%

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Prevention of neonatal group B streptococcus disease in the 21st century

Clifford

Garland

Grimwood

2011

J Paediatrics Child Health

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There have been significant reductions in early-onset neonatal group B streptococcus (GBS) disease following implementation of maternal intrapartum antibiotic prophylaxis (IAP) policies. Nevertheless, GBS remains a leading cause of neonatal sepsis in Australia and New Zealand resulting in considerable morbidity and mortality, particularly among preterm infants. In the United States, the universal screening-based approach for identifying women for IAP results in apparently lower rates of early-onset neonatal GBS infection than risk-based assessment. In addition, IAP has altered the profile of newborn infants who develop early-onset disease. Many affected infants lack the typical intrapartum risk factors for GBS infection, are born to mothers with a negative GBS screen or represent missed opportunities for prevention. Clinicians should remain alert for signs of sepsis in any newborn infant. We provide an update of GBS preventative management strategies in the perinatal period taking into account recent United States, Australian and New Zealand guidelines.

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“…The gastrointestinal tract serves as the natural reservoir for GBS and is expected to be the source of vaginal colonization 23,43 . Pregnant women who are colonized with GBS might develop infections of the urinary tract, bacteremia, chorioamnionitis, and postpartum endometritis 23,47,48 , thus increasing the risk of PTD, PPROM and perinatal transmission [49][50][51] , resulting in neonatal sepsis and meningitis 45,52,53 . A prevalence of 7 -25% GBS colonization in AV has been reported in women between 35 and 37 weeks of gestation 54 , with intrauterine infection associated with the ability of GBS to ascend from the lower genital tract and colonize the upper genital tract [54][55][56] .…”

Section: Group B Streptococci (Gbs)mentioning

confidence: 99%

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

Kaambo

Africa

2017

Afr J Reprod Health

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Aerobic vaginitis (AV) is an endogenous opportunistic infection brought about by the disruption of the normal vaginal microbiota. Its early diagnosis and treatment during pregnancy may reduce the risk of negative pregnancy outcomes. The aim of this review was to report on the aerobic bacteria most prevalent in AV and to provide evidence of the threat of untreated AV on pregnancy outcomes. More than 300 papers on preterm delivery were extracted from several research domains and filtered to include only AV-associated bacteria such as Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Group B streptococci and their association with adverse pregnancy outcomes. Due to the diverse sample groups, study techniques and outcomes, a meta-analysis was not conducted. The review revealed that the association of AV with adverse pregnancy outcomes has not been as widely researched as bacterial vaginosis (BV) and needs further investigation. Furthermore, the frequent misdiagnosis of AV coupled with the emerging antimicrobial resistance associated with bacteria implicated in AV and neonatal nosocomial infections pose a problem for prophylaxis and treatment to reduce the risk of maternal and neonatal morbidity and mortality. (Afr J Reprod Health 2017; 21[2]: 109-118). Keywords: Aerobic vaginitis; pregnancy risks; antimicrobial resistance RésuméLa vaginite aérobie (VA) est une infection opportuniste endogène provoquée par la perturbation du microbiota vaginal normal. Son diagnostic précoce et son traitement pendant la grossesse peuvent réduire le risque de résultats négatifs de grossesse. L'objectif de cette revue était de faire un rapport sur les bactéries aérobies les plus répandues en VA et de prouver la menace de la VA non traitée sur les résultats de la grossesse. Plus de 300 articles sur l'accouchement prématuré ont été tirés de plusieurs domaines de recherche et filtrés pour inclure uniquement des bactéries associées à la VA telles que Staphylococcus aureus, Enterococcus faecalis, Escherichia coli et streptocoques du groupe B et leur association avec des résultats de grossesse indésirables. En raison des divers groupes d'échantillons, des techniques d'étude et des résultats, une méta-analyse n'a pas été menée. L'examen a révélé que l'association de la VA avec les résultats de grossesse défavorisés n'a pas été aussi largement étudiée que la vaginose bactérienne (VB) et doit faire l'objet d'une enquête plus approfondie. En outre, le diagnostic erroné de la VA y compris la résistance antimicrobienne émergente associée à une bactérie impliquée dans les infections à vent et nonnéomatologiques constitue un problème pour la prophylaxie et le traitement afin de réduire le risque de morbidité et de mortalité maternelle et néonatale. (Afr J Reprod Health 2017; 21[2]: 109-118).

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Antenatal screening for Group B Streptococcus: A diagnostic cohort study

Cited by 22 publications

References 16 publications

Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization

Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization

Prevention of neonatal group B streptococcus disease in the 21st century

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

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