Clinical impact of rapid polymerase chain reaction (PCR) test for group B Streptococcus (GBS) in term women with ruptured membranes
| Autor: | Susan J Knowles, Michael J Doyle, Enya F Fullston, Mary Higgins |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Fetal Membranes Premature Rupture medicine.drug_class Antibiotics 030204 cardiovascular system & hematology medicine.disease_cause Polymerase Chain Reaction Group B Streptococcus agalactiae 03 medical and health sciences Young Adult 0302 clinical medicine Pregnancy Risk Factors Internal medicine Streptococcal Infections medicine Rupture of membranes Antimicrobial stewardship Humans Mass Screening 030212 general & internal medicine Antibiotic prophylaxis Pregnancy Complications Infectious reproductive and urinary physiology Retrospective Studies GeneXpert MTB/RIF Streptococcus business.industry Infant Newborn Retrospective cohort study General Medicine Antibiotic Prophylaxis Middle Aged Anti-Bacterial Agents Female business |
| Zdroj: | Irish journal of medical science. 188(4) |
| ISSN: | 1863-4362 |
| Popis: | Early-onset group B Streptococcus (EOGBS/GBS) infection remains a significant cause of neonatal morbidity and mortality. Aiming to improve antimicrobial stewardship and reduce unnecessary maternal and infant exposure to intrapartum antibiotic prophylaxis (IAP), this study assessed the clinical use of a commercially available GBS polymerase chain reaction (PCR) assay for term women with pre-labour rupture of membranes. This was a retrospective study in a tertiary level maternity unit of term women with pre-labour rupture of membranes (ROM), without any clinical suspicion of infection performed between November and December 2017. GBS PCR tests were cross-referenced with patient clinical data. PCR test results, the impact of testing on antibiotic administration, pyrexia in labour, induction, interventional delivery rates and neonatal outcomes were analysed. Of 200 patients included in the study, 29 were positive (14.5%) and 166 were negative (83%), with five invalid results (2.5%). One hundred and twenty three women had > 18-h ruptured membranes and 86 women (70%) who would have been eligible for IAP based on risk factors avoided antibiotic therapy following a negative PCR test. There were no significant differences in induction or interventional delivery rates between GBS-positive and GBS-negative women following PCR testing. During the study period, there were no cases of EOGBS. In a centre adhering to a risk-factor-based GBS policy, the introduction of limited rapid GBS screening for term women with pre-labour rupture of membranes resulted in a clinically significant reduction in prophylactic antibiotic use. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink