Significance of a positive urine group B streptococcal latex agglutination test in neonates

Sánchez, Pablo J.; Siegel, Jane D.; Cushion, N.; Threlkeld, Norma

doi:10.1016/s0022-3476(05)81613-0

Cited by 35 publications

(21 citation statements)

References 11 publications

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“…The sensitivity of latex particle agglutination compared to culture for the detection of invasive GBS disease has been reported at 72 to 89% for CSF and slightly lower for urine (26,271). However, a number of studies have shown that GBS antigen is often detectable in the urine in the absence of a positive blood culture, possibly due to surface colonization (404), absorption of GBS antigen from the gastrointestinal tract (360), or maternal treatment with antibiotics to prevent neonatal bacteremia (191). Thus, while the sensitivity and negative predictive value of urine GBS latex agglutination are high, false-positive rates as high as 30% have limited its usefulness as a screening tool for sepsis in neonates, and many laboratories have discontinued testing for urine GBS antigen (502).…”

Section: Nonculture Microbiological Methods For Predicting Bloodstreamentioning

confidence: 99%

Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants

2004

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Twenty percent of very-low-birth-weight (<1500 g) preterm infants experience a serious systemic infection, and despite advances in neonatal intensive care and antimicrobials, mortality is as much as threefold higher for these infants who develop sepsis than their counterparts without sepsis during their hospitalization. Outcomes may be improved by preventative strategies, earlier and accurate diagnosis, and adjunct therapies to combat infection and protect the vulnerable preterm infant during an infection. Earlier diagnosis on the basis of factors such as abnormal heart rate characteristics may offer the ability to initiate treatment prior to the onset of clinical symptoms. Molecular and adjunctive diagnostics may also aid in diagnosing invasive infection when clinical symptoms indicate infection but no organisms are isolated in culture. Due to the high morbidity and mortality, preventative and adjunctive therapies are needed. Prophylaxis has been effective in preventing early-onset group B streptococcal sepsis and late-onset Candida sepsis. Future research in prophylaxis using active and passive immunization strategies offers prevention without the risk of resistance to antimicrobials. Identification of the differences in neonatal intensive care units with low and high infection rates and implementation of infection control measures remain paramount in each neonatal intensive care unit caring for preterm infants

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Section: Nonculture Microbiological Methods For Predicting Bloodstreamentioning

confidence: 99%

Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants

2004

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“…12,20 Confirmatory diagnosis of bacterial sepsis or meningitis is only possible with appropriate culture Nonetheless, failure to follow a guideline adequately, results in an increase in the risk. [38][39][40][41][42][43] Although there was no identified issues with the performance of the test or incompleteness in the sampling procedure in this study (i.e., all positive neonatal blood cultures for GBS had an accompanying positive antigen screen), prevalence in this population has been significantly reduced from what has been previously described in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…10 A positive or negative group B streptococcal result only reflected whether or not there is group B streptococcal antigen present at sufficient concentration in the sample measured and is not diagnostic for group B streptococcal disease. 11,12 Although the serum bacterial antigen was not specifically mentioned in the recommendations for the evaluation of newborn sepsis, its clinical use for GBS evaluation has continued in a number of venues. 8 Very little information is available regarding the use of serum bacterial antigens in determination of neonatal sepsis.…”

Section: Introductionmentioning

confidence: 99%

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Use of the Serum Bacterial Antigen Test for the Detection of Group B Streptococcal Neonatal Sepsis

Goldstein

Yang

Martin

et al. 2015

Newborn and Infant Nursing Reviews

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“…A positive ULA in light of a negative blood culture may be due to suppression of bacterial growth in the patient's blood culture, a low-grade bacteraemia, other substances which crossreact with the GBS antigens in the urine, skin and mucosal surface contamination, and transient antigenuria from gastrointestinal absorption. [13][14][15] Despite these reasons, we believe that a positive ULA with a negative blood culture for GBS in a symptomatic patient was enough evidence for the presence of GBS infection since these patients presented in septic shock requiring ECMO support.…”

Section: Discussionmentioning

confidence: 99%

The use of extracorporeal membrane oxygenation in patients with Gram-negative or viral sepsis

et al. 1997

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To evaluate the use of extracorporeal membrane oxygenation (ECMO) in patients with Gram-negative or viral sepsis, a survey of ECMO centres comprising the Extracorporeal Life Support Organization was conducted. Data collected from neonatal and paediatric intensive care units included patient demographics, indicators of infection, presence of cardiac instability and respiratory criteria for ECMO. One-hundred-and-seven patients with documented sepsis were divided into survivors and nonsurvivors. Prior to ECMO, the patients with a persistent metabolic acidosis (p < 0.008) and/or hypotension requiring more than two inotropic agents (p < 0.02) to support blood pressure were less likely to survive. Also, patients with Gram-positive infections (77%) were more likely to survive their ECMO course than those with Gram-negative (60%) or viral infections (40%). Although survival is less in septic infants than in infants with traditional respiratory failure placed on ECMO, sepsis should not be a contraindication to the use of ECMO. The parents should be informed of the chances of survival with each type of sepsis or respiratory infection (if known), so that a truly informed decision can be made by the parents. We feel that the additional information regarding Gram-negative and viral sepsis should assist the clinician in this goal.

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Significance of a positive urine group B streptococcal latex agglutination test in neonates

Cited by 35 publications

References 11 publications

Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants

Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants

Use of the Serum Bacterial Antigen Test for the Detection of Group B Streptococcal Neonatal Sepsis

The use of extracorporeal membrane oxygenation in patients with Gram-negative or viral sepsis

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