Screening for Streptococcus agalactiae in pregnancy – do we need to take a step forward?
DOI:
https://doi.org/10.6016/ZdravVestn.1372Keywords:
pregnancy, neonatal infections, Streptococcus agalactiae, diagnostic methods, molecular detection, screeningAbstract
AbstractBackground: Streptococcus agalactiae is the leading infectious cause of morbidity among neonates. Majority of early onset neonatal infections can be prevented using antimicrobial prophylaxis during labour. Different diagnostic procedures can be employed to detect maternal colonization during pregnancy and labour. In the present study we analysed diagnostic characteristics of two common methods for detection of S. agalactiae.
Methods: One hundred and one consecutive vaginal or combined vaginal-rectal swabs were included in this prospective study. All samples were tested with enrichment culture and molecular illumigene GBS assay. Results of repeatedly disconcordant samples were retested and confirmed with a different molecular assay. Sensitivity, specificity, positive and negative predicted values were determined for both assays.
Results: Mean age of women was 33 years. Prevalence of colonisation in the sample was 23,8 %. Positivity rates using enrichment culture only, illumigene GBS assay only and combination of both assays were 19,8 %, 22,7 % and 23,8 %, respectively. Sensitivity, specificity, positive and negative predictive values were 83,3 %, 100 %, 100 % in 95,1 % for enrichment culture and 95,8 %, 100 %, 100 % in 98,7 % for illumigene GBS assay, respectively. Combining both methods 20 % more colonized women were detected compared to enrichment culture alone.
Conclusions: With a combination of enrichment culture and illumigene GBS assay we can detect substantially more colonized women compared to currently most frequently used method of enrichment culture. Comprehensive evaluation of current strategies for prevention of S. agalactiae early neonatal infection is warranted in Slovenia.
Downloads
References
Okike IO, Johnson AP, Henderson KL, Blackburn RM, Muller-Pebody B, Ladhani SN, et al. Incidence, etiology, and outcome of bacterial meningitis in infants aged. Clin Infect Dis. 2014; 59: e150–7.
Edmond KM, Kortsalioudaki C, Scott S, Schrag SJ, Zaidi AKM, Cousens S, et al. Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. Lancet. 2012; 379: 547–56.
Verani JR, McGee L, Schrag SJ, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010; 59: 1–36.
Weston EJ, Pondo T, Lewis MM, Martell-Cleary P, Morin C, Jewell B, et al. The burden of invasive early-onset neonatal sepsis in the United States, 2005-2008. Pediatr Infect Dis J. 2011; 30: 937–41.
Bizzarro MJ, Raskind C, Baltimore RS, Gallagher PG. Seventy-five years of neonatal sepsis at Yale: 1928-2003. Pediatrics. 2005; 116: 595–602.
Sheehy A, Davis D, Homer CSE. Assisting women to make informed choices about screening for group B streptococcus in pregnancy: a critical review of the evidence. Women Birth. 2013; 26: 152–7.
Simonsen KA, Anderson-Berry AL, Delair SF, Davies HD. Early-onset neonatal sepsis. Clin Microbiol Rev. 2014; 27: 21–47.
Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L, Nadisauskiene R. Prevalence of maternal group B streptococcal colonisation in European countries. Acta Obstet Gynecol Scand. 2008; 87: 260–71.
Boyer KM, Gotoff SP. Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N Engl J Med. 1986; 314: 1665–9.
Di Renzo GC, Melin P, Berardi A, Blennow M, Carbonell-Estrany X, Donzelli GP, et al. Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference. J Matern Fetal Neonatal Med. 2014; Early Online: 1–17.
Schrag SJ, Zell ER, Lynfield R, Roome A, Arnold KE, Craig AS, et al. A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates. N Engl J Med. 2002; 347: 233–9.
van Dyke MK, Phares CR, Lynfield R, Thomas AR, Arnold KE, Craig AS, et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009; 360: 2626–36.
Vovko P. Assesment of laboratory procedures for group B streptococci screening in pregnant women. Zdrav Vestn. 2007; 76: 33–9.
Platt MW, McLaughlin JC, Gilson GJ, Wellhoner MF, Nims LJ. Increased recovery of group B streptococcus by the inclusion of rectal culturing and enrichment. Diagn Microbiol Infect Dis. 1995; 21: 65–8.
Yancey MK, Schuchat A, Brown LK, Ventura VL, Markenson GR. The accuracy of late antenatal screening cultures in predicting genital group B streptococcal colonization at delivery. Obstet Gynecol. 1996; 88: 811–5.
Yancey MK, Armer T, Clark P, Duff P. Assessment of rapid identification tests for genital carriage of group B streptococci. Obstet Gynecol. 1992; 80: 1038–47.
Couturier BA, Weight T, Elmer H, Schlaberg R. Antepartum screening for group B streptococcus by three FDA-cleared molecular tests and effect of shortened enrichment culture on molecular detection rates. J Clin Microbiol. 2014; 52: 3429–32.
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: 3615–20.
Goodrich JS, Miller MB. Comparison of culture and 2 real-time polymerase chain reaction assays to detect group B streptococcus during antepartum screening. Diagn Microbiol Infect Dis. 2007; 59: 17–22.
Berg BR, Houseman JL, Garrasi MA, Young CL, Newton DW. Culture-based method with performance comparable to that of PCR-based methods for detection of group B streptococcus in screening samples from pregnant women. J Clin Microbiol. 2013; 51: 1253–5.
Aila El NA, Tency I, Claeys G, Verstraelen H, Deschaght P, Decat E, et al. Comparison of culture with two different qPCR assays for detection of rectovaginal carriage of Streptococcus agalactiae (group B streptococci) in pregnant women. Res Microbiol. 2011; 162: 499–505.
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: 4495–500.
Verhoeven PO, Noyel P, Bonneau J, Carricajo A, Fonsale N, Ros A, et al. Evaluation of the new brilliance GBS chromogenic medium for screening of Streptococcus agalactiae vaginal colonization in pregnant women. J Clin Microbiol. 2014; 52: 991–3.
Morita T, Feng D, Kamio Y, Kanno I, Somaya T, Imai K, et al. Evaluation of chromID strepto B as a screening media for Streptococcus agalactiae. BMC Infect Dis. 2014; 14: 46.
Horváth B, Grasselly M, Bödecs T, Boncz I, Bódis J. Screening pregnant women for group B streptococcus infection between 30 and 32 weeks of pregnancy in a population at high risk for premature birth. Int J Gynaecol Obstet. 2013; 122: 9–12.
Mueller M, Henle A, Droz S, Kind AB, Rohner S, Baumann M, et al. Intrapartum detection of Group B streptococci colonization by rapid PCR-test on labor ward. Eur J Obstet Gynecol Reprod Biol. 2014; 176: 137–41.
Downloads
Published
Issue
Section
License
The Author transfers to the Publisher (Slovenian Medical Association) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Slovenian Medical Association) has the right to transfer the rights of acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
