Real-time PCR-assay in the delivery suite for determination of group B streptococcal colonization in a setting with risk-based antibiotic prophylaxis

Research output: Contribution to journalArticle

Abstract

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.

Details

Authors
  • Stellan Hakansson
  • Karin Källén
  • Maria Bullarbo
  • Per-Ake Holmgren
  • Katarina Bremme
  • Asa Larsson
  • Margareta Norman
  • Hakan Noren
  • Catharina Ortmark-Wrede
  • Karin Pettersson
  • Sissel Saltvedt
  • Birgitta Sondell
  • Magdalena Tokarska
  • Anna von Vultee
  • Bo Jacobsson
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Obstetrics, Gynecology and Reproductive Medicine

Keywords

  • Antibiotics, delivery, prophylaxis, real-time PCR, S. agalactiae
Original languageEnglish
Pages (from-to)328-332
JournalJournal of Maternal-Fetal & Neonatal Medicine
Volume27
Issue number4
Publication statusPublished - 2014
Publication categoryResearch
Peer-reviewedYes