Evaluation of Polymerase Chain Reaction for Group B Streptococcus Detection Using an Improved Culture Method

Atkins, Kristin; Atkinson, Robyn; Shanks, Anthony; Parvin, Curtis A.; Dunne, W. Michael; Gross, Gilad A.

doi:10.1097/01.aog.0000228961.42272.31

Cited by 41 publications

(33 citation statements)

References 17 publications

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“…Using improved diagnostic instruments such as PCR for detecting GBS may result in reasonable utilization of antibiotics. In fact, combining rapid sampling with rapid proliferation and identifying technologies can aid to improve the control and prevention of infectious diseases (11).…”

Section: Discussionmentioning

confidence: 99%

Direct Identification of Streptococcus agalactiae in Vaginal Colonization in Pregnant Women Using Polymerase Chain Reaction

et al. 2014

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Background: Streptococcus agalactiae is a commensal organism, but it may cause infection in susceptible hosts including newborns as well as in pregnant or postpartum women. Applying rapid, accurate and sensitive methods for detecting group B Streptococcus (GBS) and receiving intrapartum antibiotic prophylaxis (IAP) at delivery have been demonstrated to increase the treatment possibility of carrier pregnant women and decrease the rates of GBS vertical transmission to infants. Objectives: The aim of this study was to compare the PCR assay results targeting 16S rRNA primers with the conventional culture method for direct detection of GBS in vaginal specimens of pregnant women at 35-37 weeks of gestation in Hamadan, Iran. Patients and Methods: A total of 203 vaginal specimens of pregnant women at 35-37 weeks of pregnancy from June 2013 through February 2014 were evaluated for detection of GBS, using culture method and polymerase chain reaction (PCR). Results: The prevalence of GBS in the 203 collected samples was 7.39% using culture method and 19.70% using PCR. Twenty-five specimens had positive PCR results and negative cultures; two specimens were positive in culture and negative by PCR.A total of 42 specimens (20.69%) were considered as true positive. The PCR results in comparison with culture (as the gold standard) revealed sensitivity of 88.24%, specificity of 87.44%, positive and negative predictive value of 35.71% and 98.95% respectively, and accuracy of 87.50%. Conclusions: Performing only culture method led to missed false negative carriers. Therefore, it is recommended that both the PCR assay and conventional culture method be routinely performed to detect GBS in pregnant women accurately. PCR diagnosis demonstrated a shorter turnaround time when compared with the time consuming culture method.

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Section: Discussionmentioning

confidence: 99%

Direct Identification of Streptococcus agalactiae in Vaginal Colonization in Pregnant Women Using Polymerase Chain Reaction

et al. 2014

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“…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%

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

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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.

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“…Entre los estudios que emplean la qPCR se encuentran; el realizado en chicago en el cual la sensibilidad y especificidad fue del 95,8%, y del 64,5% 17 . Atkins y col en Washington reportaron una sensibilidad y especificidad del 86,8% y 95,2% 14 . Young y colaboradores en Boston una sensibilidad de 90,8%; y especificidad de 97,6%.…”

Section: Introductionunclassified

Evaluación de una técnica de PCR en tiempo real para determinar colonización por Streptococcus agalactiae en mujeres gestantes de Medellín que consultan en Dinamica IPS

Duque

Sánchez

Gómez³

et al. 2017

Infect

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ResumenObjetivo: Evaluar una técnica de PCR en tiempo real para determinar colonización por Streptococcus agalactiae en mujeres gestantes de Medellín. Materiales Y Métodos: Se realizó un estudio descriptivo prospectivo, en 150 mujeres gestantes, seleccionadas de forma aleatoria, en una IPS en el periodo comprendido entre Enero-Julio 2016. Criterio de inclusión: ser gestante entre la semana 35-37, declaración voluntaria de participación en el estudio y de exclusión el uso de antibióticos. A las pacientes, se les tomó muestra con hisopo del introito vaginal y de la región anal. Las muestras se procesaron para qPCR, cultivo en caldo selectivo con posterior siembra en agar sangre de carnero y medio cromogénico para S. agalactiae STRB (ChromIDTMStrepto,BioMérieux SA.). Resultados: La prevalencia de colonización por S. agalactiae en las gestantes fue de 20,9% y 22,3 % en agar sangre y agar cromogénico STRB respectivamente, mientras que mediante PCR en tiempo real la prevalencia fue de 36%. Al comparar la qPCR con la prueba de oro se encontró: sensibilidad 79,31% (IC del 95%: 0,61-0,90), especificidad 75,45% (IC del 95%: 0,66-0,82), valor predictivo positivo 46% (IC del 95%:0,32-0,59) y negativo 93,2% (IC del 95%: 0,86-0,96). Discusión: El empleo de la qPCR permitió aumentar la sensibilidad y la oportunidad diagnostica (El tiempo requerido empleando el cultivo fue de 24-48 horas y por qPCR 6 horas), impactando la reducción de riesgos de transmisión neonatal de S. agalactiae, lo cual podría representar una disminución en días de estancia y costos hospitalarios por una infección prevenible. Palabras clave: Streptococcus agalactiae, Cultivo, PCR en tiempo real, Colonización Evaluation of a real-time PCR technique to determine colonization by Streptococcus agalactiae in pregnant women of Medellín who consult in Dinamica IPS AbstractObjective: To evaluate a real-time qPCR technique to determine colonization by Streptococcus agalactiae in pregnant women from Medellín. Materials and Methods: A prospective and descriptive study was conducted in 150 pregnant women, randomly selected, at an IPS between January and July 2016. Inclusion criteria: gestation period week 35-37, voluntary declaration of participation in the study. Exclusion criteria: the use of antibiotics. Samples were taken from the vaginal introitus and the anal region using a hyssop and processed for qPCR as well as the gold standard test [selective broth culture with subsequent culture in blood agar and chromogenic medium for S. agalactiae STRB (ChromIDTMStrepto, BioMérieux SA)].Results: The prevalence of colonization by S. agalactiae in pregnant women was 20.9% and 22.3% in blood agar and chromogenic agar STRB respectively, whereas using qPCR the prevalence was 36.0%. The time required using the culture was 24-48h compared to 6h for qPCR. Our data comparing qPCR with the gold standard test showed: sensitivity 79.31% (95% CI: 0.61-0.90), specificity 75.45% (95% CI: 0.66-0.82), positive predictive value 46.0% (95% CI: 0.32-0.59) and negative 93.2% (95% CI: 0.86-0....

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Evaluation of Polymerase Chain Reaction for Group B Streptococcus Detection Using an Improved Culture Method

Abstract: Although a rapid PCR assay may be useful to determine GBS status in the urgent intrapartum setting, the false-negative rate of 13.2% for the real-time PCR assay prohibits its use for standard GBS screening in the office.

Cited by 41 publications

References 17 publications

Direct Identification of Streptococcus agalactiae in Vaginal Colonization in Pregnant Women Using Polymerase Chain Reaction

Direct Identification of Streptococcus agalactiae in Vaginal Colonization in Pregnant Women Using Polymerase Chain Reaction

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Evaluación de una técnica de PCR en tiempo real para determinar colonización por Streptococcus agalactiae en mujeres gestantes de Medellín que consultan en Dinamica IPS

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