Abstract
Objective: The purpose of this study was to evaluate the Equate Strep B® test for clinical use in patients at high risk for complications from group B streptococcus (GBS) disease.
Methods: Vaginoperineal swabs were obtained from patients with preterm premature rupture of the membranes and/or preterm labor and semiquantitative GBS cultures and Equate® assay were performed.
Results: From May 14, 1990, to April 30, 1992, 650 patients were enrolled; 626 had both culture and Equate® results available, of whom 24% were colonized with GBS. The sensitivity, specificity, positive predictive value, and negative predictive value of the rapid assay were 28%, 84%, 35%, and 79%, respectively. Although the prevalence of GBS was higher in patients with ruptured membranes compared with those with intact membranes, rupture of membranes did not affect test sensitivity or specificity.
Conclusions: We conclude that the Equate® rapid assay is not a sensitive method of GBS detection in high-risk patients.
Full Text
The Full Text of this article is available as a PDF (386.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allardice J. G., Baskett T. F., Seshia M. M., Bowman N., Malazdrewicz R. Perinatal group B streptococcal colonization and infection. Am J Obstet Gynecol. 1982 Mar 15;142(6 Pt 1):617–620. doi: 10.1016/s0002-9378(16)32429-2. [DOI] [PubMed] [Google Scholar]
- Armer T., Clark P., Duff P., Saravanos K. Rapid intrapartum detection of group B streptococcal colonization with an enzyme immunoassay. Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):39–43. doi: 10.1016/s0002-9378(12)90881-9. [DOI] [PubMed] [Google Scholar]
- Boyer K. M., Gadzala C. A., Kelly P. D., Burd L. I., Gotoff S. P. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. II. Predictive value of prenatal cultures. J Infect Dis. 1983 Nov;148(5):802–809. doi: 10.1093/infdis/148.5.802. [DOI] [PubMed] [Google Scholar]
- Boyer K. M., Gotoff S. P. Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N Engl J Med. 1986 Jun 26;314(26):1665–1669. doi: 10.1056/NEJM198606263142603. [DOI] [PubMed] [Google Scholar]
- Brady K., Duff P., Schilhab J. C., Herd M. Reliability of a rapid latex fixation test for detecting group B streptococci in the genital tract of parturients at term. Obstet Gynecol. 1989 Apr;73(4):678–681. [PubMed] [Google Scholar]
- Clark P., Armer T., Duff P., Davidson K. Assessment of a rapid latex agglutination test for group B streptococcal colonization of the genital tract. Obstet Gynecol. 1992 Mar;79(3):358–363. doi: 10.1097/00006250-199203000-00006. [DOI] [PubMed] [Google Scholar]
- Gentry Y. M., Hillier S. L., Eschenbach D. A. Evaluation of a rapid enzyme immunoassay test for detection of group B Streptococcus. Obstet Gynecol. 1991 Sep;78(3 Pt 1):397–401. [PubMed] [Google Scholar]
- Granato P. A., Petosa M. T. Evaluation of a rapid screening test for detecting group B streptococci in pregnant women. J Clin Microbiol. 1991 Jul;29(7):1536–1538. doi: 10.1128/jcm.29.7.1536-1538.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Green M., Dashefsky B., Wald E. R., Laifer S., Harger J., Guthrie R. Comparison of two antigen assays for rapid intrapartum detection of vaginal group B streptococcal colonization. J Clin Microbiol. 1993 Jan;31(1):78–82. doi: 10.1128/jcm.31.1.78-82.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greenspoon J. S., Fishman A., Wilcox J. G., Greenspoon R. L., Lewis W. Comparison of culture for group B streptococcus versus enzyme immunoassay and latex agglutination rapid tests: results in 250 patients during labor. Obstet Gynecol. 1991 Jan;77(1):97–100. [PubMed] [Google Scholar]
- Kontnick C. M., Edberg S. C. Direct detection of group B streptococci from vaginal specimens compared with quantitative culture. J Clin Microbiol. 1990 Feb;28(2):336–339. doi: 10.1128/jcm.28.2.336-339.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Minkoff H., Mead P. An obstetric approach to the prevention of early-onset group B beta-hemolytic streptococcal sepsis. Am J Obstet Gynecol. 1986 May;154(5):973–977. doi: 10.1016/0002-9378(86)90731-3. [DOI] [PubMed] [Google Scholar]
- Morales W. J., Lim D. V., Walsh A. F. Prevention of neonatal group B streptococcal sepsis by the use of a rapid screening test and selective intrapartum chemoprophylaxis. Am J Obstet Gynecol. 1986 Nov;155(5):979–983. doi: 10.1016/0002-9378(86)90329-7. [DOI] [PubMed] [Google Scholar]
- Morales W. J., Lim D. Reduction of group B streptococcal maternal and neonatal infections in preterm pregnancies with premature rupture of membranes through a rapid identification test. Am J Obstet Gynecol. 1987 Jul;157(1):13–16. doi: 10.1016/s0002-9378(87)80336-8. [DOI] [PubMed] [Google Scholar]
- Skoll M. A., Mercer B. M., Baselski V., Gray J. P., Ryan G., Sibai B. M. Evaluation of two rapid group B streptococcal antigen tests in labor and delivery patients. Obstet Gynecol. 1991 Feb;77(2):322–326. doi: 10.1097/00006250-199102000-00035. [DOI] [PubMed] [Google Scholar]
- Towers C. V., Garite T. J., Friedman W. W., Pircon R. A., Nageotte M. P. Comparison of a rapid enzyme-linked immunosorbent assay test and the Gram stain for detection of group B streptococcus in high-risk antepartum patients. Am J Obstet Gynecol. 1990 Sep;163(3):965–967. doi: 10.1016/0002-9378(90)91105-l. [DOI] [PubMed] [Google Scholar]
- Tuppurainen N., Hallman M. Prevention of neonatal group B streptococcal disease: intrapartum detection and chemoprophylaxis of heavily colonized parturients. Obstet Gynecol. 1989 Apr;73(4):583–587. [PubMed] [Google Scholar]
- Yancey M. K., Armer T., Clark P., Duff P. Assessment of rapid identification tests for genital carriage of group B streptococci. Obstet Gynecol. 1992 Dec;80(6):1038–1047. [PubMed] [Google Scholar]
