Diagnostic Accuracy of a Rapid Real‐Time Polymerase Chain Reaction Assay for Universal Intrapartum Group B Streptococcus Screening

Helali, Najoua El; N'guyen, Jean-Claude; Ly, Aïcha; Giovangrandi, Yves; Trinquart, Ludovic

doi:10.1086/600303

Cited by 146 publications

(166 citation statements)

References 28 publications

Supporting

Mentioning

147

Contrasting

Unclassified

Order By: Relevance

“…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%

“…A substantial number of positive mothers for GBS at delivery, up to 30-50%, are not identified as carriers by antenatal cultures and up to 25-40% of women identified as GBS carriers are no longer positive at the time of delivery [10,79,82]. Whether negative antenatal cultures were falsenegative results or the mothers acquired GBS in the interval between the screening culture and the time of delivery is unknown.…”

Section: Timing Of Screeningmentioning

confidence: 99%

See 2 more Smart Citations

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

View full text Add to dashboard Cite

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.

show abstract

Section: Non-culture Methods For Intrapartum Specimen Processingmentioning

confidence: 99%

Section: Timing Of Screeningmentioning

confidence: 99%

Section: Timing Of Screeningmentioning

confidence: 99%

See 1 more Smart Citation

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

View full text Add to dashboard Cite

show abstract

“…Xpert Ò GBS targets the same gene as IDI-Strep B TM and provides even better results than the latter assay [18]. In 2009, a French study showed that the intrapartum test with Xpert Ò GBS was highly sensitive and specific and provided a much higher positive predictive value for intrapartum GBS colonization (97.8 %) than antenatal cultures (58.3 %) [7]. These results should be interpreted with caution, because antenatal cultures were not performed as recommended to reach optimal sensitivity, thus favoring the sensitivity of PCR and lowering the positive predictive value of antenatal cultures.…”

Section: Polymerase Chain Reactionmentioning

confidence: 99%

“…Nevertheless, several studies have shown a low sensitivity of antenatal GBS cultures to detect colonization during labor [7][8][9]. Cases of EOD in infants born at term have occurred among mothers with negative antenatal GBS culture results and it has been reported that at least 10 % of this group of women turned positive at labor [10].…”

Section: Introductionmentioning

confidence: 99%

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

2013

View full text Add to dashboard Cite

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.

show abstract

Real-time polymerase chain reaction tests versus antenatal culture tests for the screening of maternal group B Streptococcus colonisation in labour

Seedat

Cooper

Uthman

et al. 2018

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Diagnostic Accuracy of a Rapid Real‐Time Polymerase Chain Reaction Assay for Universal Intrapartum Group B Streptococcus Screening

Abstract: This real-time PCR assay is a highly accurate test to identify intrapartum GBS carriers at point of care. This new tool could enhance the exact identification of candidates for intrapartum antibiotic prophylaxis, including women with preterm rupture of membranes or preterm labor.

Cited by 146 publications

References 28 publications

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

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

Real-time polymerase chain reaction tests versus antenatal culture tests for the screening of maternal group B Streptococcus colonisation in labour

Contact Info

Product

Resources

About