Real-time PCR-assay in the delivery suite for determination of group B streptococcal colonization in a setting with risk-based antibiotic prophylaxis
2014 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, Vol. 27, no 4, 328-332 p.Article in journal (Refereed) Published
Objective: Intrapartum antibiotic prophylaxis (IAP) reduces the incidence of neonatal early onset group B streptococcal infections. The present study investigated if an automated PCR-assay, used bedside by the labor ward personnel was manageable and could decrease the use of IAP in a setting with a risk-based IAP strategy. Methods: The study comprises two phases. Phase 1 was a multicenter, randomized, controlled trial. Women with selected risk-factors were allocated either to PCR-IAP (prophylaxis given if positive or indeterminate) or IAP. A vaginal/rectal swab and superficial swabs from the neonate for conventional culture were also obtained. Phase 2 was non-randomized, assessing an improved version of the assay. Results: Phase 1 included 112 women in the PCR-IAP group and 117 in the IAP group. Excluding indeterminate results, the assay showed a sensitivity of 89% and a specificity of 90%. In 44 % of the PCR assays the result was indeterminate. The use of IAP was lower in the PCR group (53 versus 92%). Phase 2 included 94 women. The proportion of indeterminate results was reduced (15%). The GBS colonization rate was 31%. Conclusion: The PCR assay, in the hands of labor ward personnel, can be useful for selection of women to which IAP should be offered.
Place, publisher, year, edition, pages
Informa Healthcare, 2014. Vol. 27, no 4, 328-332 p.
Antibiotics, delivery, prophylaxis, real-time PCR, S. agalactiae
Obstetrics, Gynecology and Reproductive Medicine
IdentifiersURN: urn:nbn:se:umu:diva-86324DOI: 10.3109/14767058.2013.818128ISI: 000330068000002OAI: oai:DiVA.org:umu-86324DiVA: diva2:698830