Deborah Money1, Simon Dobson2, Lesley Cole3, Eda Karacabeyli3, Edith Blondel-Hill4, Ruth Milner5, Eva Thomas4. 1. Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of British Columbia, Vancouver BC; Women's Health Research Institute, Children's and Women's Health Centre of British Columbia, Vancouver BC. 2. Vaccine Evaluation Centre, Children's and Women's Health Centre of British Columbia, Vancouver BC. 3. Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of British Columbia, Vancouver BC. 4. Division of Microbiology, Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia, Vancouver BC. 5. Clinical Research Support Unit, Child and Family Research Institute, Vancouver BC.
Abstract
OBJECTIVE: To evaluate the sensitivity, specificity, and feasibility of a rapid real-time polymerase chain reaction (PCR) test for group B streptococcus (GBS) completed during labour, compared with the standard culture test performed at 35 to 37 weeks' gestation. METHODS: Women presenting to the maternity unit for term vaginal delivery had two vaginal/rectal samples collected. One swab was tested using a rapid PCR method (IDI-Strep B, Infectio Diagnostic [IDI] Inc., Sainte-Foy QC ), and the other was cultured after enrichment (intrapartum culture). Comparisons were made between these results and those of a culture-based screen at 35 to 37 weeks' gestation. RESULTS: Of the 190 women enrolled, 85% had results of the standard screen at 35 to 37 weeks available for comparison. The sensitivity and specificity of the standard 35- to 37-week screen were 84.3% (95% confidence interval [CI], 71.4-93.0) and 93.2% (95% CI 86.5-97.2) respectively, whereas the sensitivity and specificity of the rapid PCR were 90.7% (95% CI 79.7-96.9) and 97.6% (95% CI 93.1-99.5), respectively. The median reporting time for the rapid PCR test was 99 minutes (range 50-255). Results were available more than four hours before delivery in 81% of cases. CONCLUSION: In this Canadian centre, a rapid PCR test done at the time of labour (IDI-Strep B) demonstrated high sensitivity and specificity, comparable to the 35- to 37-week screen. The time to reporting results was acceptably short, allowing for timely administration of intrapartum prophylactic antibiotics.
OBJECTIVE: To evaluate the sensitivity, specificity, and feasibility of a rapid real-time polymerase chain reaction (PCR) test for group B streptococcus (GBS) completed during labour, compared with the standard culture test performed at 35 to 37 weeks' gestation. METHODS:Women presenting to the maternity unit for term vaginal delivery had two vaginal/rectal samples collected. One swab was tested using a rapid PCR method (IDI-Strep B, Infectio Diagnostic [IDI] Inc., Sainte-Foy QC ), and the other was cultured after enrichment (intrapartum culture). Comparisons were made between these results and those of a culture-based screen at 35 to 37 weeks' gestation. RESULTS: Of the 190 women enrolled, 85% had results of the standard screen at 35 to 37 weeks available for comparison. The sensitivity and specificity of the standard 35- to 37-week screen were 84.3% (95% confidence interval [CI], 71.4-93.0) and 93.2% (95% CI 86.5-97.2) respectively, whereas the sensitivity and specificity of the rapid PCR were 90.7% (95% CI 79.7-96.9) and 97.6% (95% CI 93.1-99.5), respectively. The median reporting time for the rapid PCR test was 99 minutes (range 50-255). Results were available more than four hours before delivery in 81% of cases. CONCLUSION: In this Canadian centre, a rapid PCR test done at the time of labour (IDI-Strep B) demonstrated high sensitivity and specificity, comparable to the 35- to 37-week screen. The time to reporting results was acceptably short, allowing for timely administration of intrapartum prophylactic antibiotics.
Authors: Feng-Ying C Lin; Leonard E Weisman; Parvin Azimi; Amy E Young; Kathleen Chang; Mikhaela Cielo; Patricia Moyer; James F Troendle; Rachel Schneerson; John B Robbins Journal: Pediatr Infect Dis J Date: 2011-09 Impact factor: 2.129