Intrapartum group B Streptococcus screening in the labor ward by Xpert® GBS real-time PCR

Autor: C. Joubrel, Claire Poyart, Céline Plainvert, Laurent Mandelbrot, Amandine Frigo, François Goffinet, Catherine Branger, M. Ballon, O. Anselem, Asmaa Tazi, F. El Alaoui
Rok vydání: 2017
Předmět:
Adult
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Point-of-care testing
030106 microbiology
Real-Time Polymerase Chain Reaction
medicine.disease_cause
Infant
Newborn
Diseases
Group B
Streptococcus agalactiae
03 medical and health sciences
Medical microbiology
Pregnancy
Streptococcal Infections
medicine
Humans
Mass Screening
Pregnancy Complications
Infectious
Antibiotic prophylaxis
Obstetrics and Gynecology Department
Hospital
reproductive and urinary physiology
Gynecology
Streptococcus
Obstetrics
business.industry
Infant
Newborn
Group B Streptococcus Screening
General Medicine
Antibiotic Prophylaxis
bacterial infections and mycoses
medicine.disease
Anti-Bacterial Agents
Infectious Diseases
Real-time polymerase chain reaction
Point-of-Care Testing
Vagina
bacteria
Female
business
Zdroj: European Journal of Clinical Microbiology & Infectious Diseases. 37:265-270
ISSN: 1435-4373
0934-9723
Popis: Group B Streptococcus (GBS) is the leading cause of neonatal infections in industrialized countries. Intrapartum antibiotic prophylaxis (IAP) given to colonized parturients is a key step for the prevention of neonatal early-onset infection. We compared the performances of Xpert® GBS polymerase chain reaction (PCR) (Cepheid, Sunnyvale, CA, USA) as a point-of-care system in labor wards to standard culture for intrapartum GBS detection. Pregnant women with a GBS-positive antenatal screening were prospectively included. A vaginal double swab was collected at the time of delivery for point-of-care Xpert® GBS PCR and GBS culture. A total of 565 pregnant women were included. Valid Xpert® GBS results were obtained for 488 (86.4%) women on the first attempt. Repeat testing improved the PCR success to 516 (91.3%) women. Among the 305 women positive for GBS by culture at delivery, only 238 (78.0%) were positive by Xpert® GBS PCR, cycle thresholds being correlated to culture quantification. Among 260 women negative for GBS culture, 56 (21.5%) were positive by Xpert® GBS PCR, including 50 where IAP was initiated before vaginal sampling. Overall, among the 565 women with GBS antenatal positive culture, only 335 (59.3%) were still positive at delivery whatever the technique used, resulting in unnecessary IAP for 40% of them. This large cohort study comparing intrapartum to antepartum GBS detection provides evidence that (i) Xpert® GBS PCR might be a valuable solution for intrapartum GBS detection compared to culture-based strategies and (ii) laboratory training of non-specialized staff is mandatory to reach the performances required for point-of-care tests.
Databáze: OpenAIRE
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