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Previous Volume 343:175-179 July 20, 2000 Number 3 Next

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ABSTRACT

Background Group B streptococcal infections are an important cause of neonatal morbidity and mortality. A rapid method for the detection of this organism in pregnant women at the time of delivery is needed to allow early treatment of neonates.

Methods We studied the efficacy of two polymerase-chain-reaction (PCR) assays for routine screening of pregnant women for group B streptococci at the time of delivery. We obtained anal, vaginal, and combined vaginal and anal specimens from 112 pregnant women; in 57 women, specimens were obtained before and after the rupture of the amniotic membranes. The specimens were tested for group B streptococci by culture in a standard selective broth medium, with a conventional PCR assay, and with a new fluorogenic PCR assay.

Results Among the 112 women, the results of the culture of the combined vaginal and anal specimens were positive for group B streptococci in 33 women (29.5 percent). The two PCR assays detected group B streptococcal colonization in specimens from 32 of these 33 women: the one negative PCR result was in a sample obtained after the rupture of membranes. As compared with the culture results, the sensitivity of both PCR assays was 97.0 percent and the negative predictive value was 98.8 percent. Both the specificity and the positive predictive value of the two PCR assays were 100 percent. The length of time required to obtain results was 30 to 45 minutes for the new PCR assay, 100 minutes for the conventional PCR assay, and at least 36 hours for culture.

Conclusions Colonization with group B streptococci can be identified rapidly and reliably by a PCR assay in pregnant women in labor both before and after the rupture of membranes.

Source Information

From the Infectious Diseases Research Center and the Division of Microbiology (M.G.B., D.K., C.M., F.J.P., M.G., M.B., M.O.) and the Department of Biochemistry and Microbiology (P.H.R.), Université Laval; the Groupe de Recherche en Épidémiologie, Centre Hospitalier Affilié Universitaire de Québec (S.M.); and the Clinical Trials Unit, Department of Obstetrics and Gynecology, Université Laval and Centre Hospitalier Universitaire de Québec (W.D.F.) — all in Quebec, Que., Canada.

Address reprint requests to Dr. Bergeron at the Infectious Diseases Research Center of Université Laval, Centre Hospitalier de Université Laval, 2705 Blvd. Laurier, Sainte-Foy, Quebec, QC G1V 4G2, Canada, or at michel.g.bergeron{at}crchul.ulaval.ca.

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