Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1994 Aug;47(8):752–755. doi: 10.1136/jcp.47.8.752

Assessment of two methods for rapid intrapartum detection of vaginal group B streptococcal colonisation.

A J Simpson 1, J A Mawn 1, S R Heard 1
PMCID: PMC502152  PMID: 7962632

Abstract

AIMS--To compare two methods for the rapid detection of intrapartum vaginal carriage of group B streptococci (Streptococcus agalactiae) with standard culture techniques and to establish their suitability for routine use. METHODS--Vaginal swabs from 266 patients in labour were incubated in glucose broth in an anaerobic atmosphere for four to six hours. The Wellcogen Strep B latex particle agglutination test kit was subsequently used for antigen detection. In the second part of the study swabs from 117 women were assessed for the presence of group B streptococci using the ICON STREP B immuno-concentration assay (Hybritech). Both methods were compared with standard semiquantitative culture on Columbia horse blood agar and Islam's medium. RESULTS--In the first study vaginal carriage of group B streptococci was shown in 38 of 266 (14.3%) patients by culture. Latex particle agglutination with the Wellcogen kit detected 30 of these positive results (sensitivity 78.9%, specificity 100%). In those patients with moderate to heavy colonisation (> 10(4) colony forming units per millilitre) antigen was detected in all (26/26) culture positive patients (sensitivity 100%, specificity 100%). In the second study 16 (13.7%) patients were culture positive. The ICON test detected 11 positive results (sensitivity 68.8%, specificity 100%) and for heavy colonisation (10(5) cfu/ml) detected nine of nine cases (sensitivity 100%, specificity 100%). The ICON test took 10 to 15 minutes to perform. CONCLUSION--These tests are potentially useful for the rapid detection of group B streptococci vaginal colonisation in labour, particularly heavy colonisation. Both tests are insufficiently sensitive to replace standard culture methods.

Full text

PDF
752

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. 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]
  3. Boyer K. M., Gadzala C. A., Kelly P. D., Gotoff S. P. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. III. Interruption of mother-to-infant transmission. J Infect Dis. 1983 Nov;148(5):810–816. doi: 10.1093/infdis/148.5.810. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Easmon C. S., Hastings M. J., Deeley J., Bloxham B., Rivers R. P., Marwood R. The effect of intrapartum chemoprophylaxis on the vertical transmission of group B streptococci. Br J Obstet Gynaecol. 1983 Jul;90(7):633–635. doi: 10.1111/j.1471-0528.1983.tb09280.x. [DOI] [PubMed] [Google Scholar]
  6. Fischer G., Horton R. E., Edelman R. From the National Institute of Allergy and Infectious Diseases. Summary of the National Institutes of Health workshop on group B streptococcal infection. J Infect Dis. 1983 Jul;148(1):163–166. doi: 10.1093/infdis/148.1.163. [DOI] [PubMed] [Google Scholar]
  7. 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]
  8. 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]
  9. Islam A. K. Rapid recognition of group-B Streptococci. Lancet. 1977 Jan 29;1(8005):256–257. doi: 10.1016/s0140-6736(77)91055-8. [DOI] [PubMed] [Google Scholar]
  10. Jones D. E., Friedl E. M., Kanarek K. S., Williams J. K., Lim D. V. Rapid identification of pregnant women heavily colonized with group B streptococci. J Clin Microbiol. 1983 Sep;18(3):558–560. doi: 10.1128/jcm.18.3.558-560.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Jones D. E., Kanarek K. S., Lim D. V. Group B streptococcal colonization patterns in mothers and their infants. J Clin Microbiol. 1984 Sep;20(3):438–440. doi: 10.1128/jcm.20.3.438-440.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. 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]
  13. Regan J. A., Klebanoff M. A., Nugent R. P. The epidemiology of group B streptococcal colonization in pregnancy. Vaginal Infections and Prematurity Study Group. Obstet Gynecol. 1991 Apr;77(4):604–610. [PubMed] [Google Scholar]
  14. Stiller R. J., Blair E., Clark P., Tinghitella T. Rapid detection of vaginal colonization with group B streptococci by means of latex agglutination. Am J Obstet Gynecol. 1989 Mar;160(3):566–568. doi: 10.1016/s0002-9378(89)80028-6. [DOI] [PubMed] [Google Scholar]
  15. Teti G., Burdash N. M., Corey K., Fava C. Detection of group B streptococci by agglutination testing from selective broth cultures. Ann Clin Lab Sci. 1985 Jul-Aug;15(4):292–298. [PubMed] [Google Scholar]
  16. 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]
  17. Van Oppen C., Feldman R. Antibiotic prophylaxis of neonatal group B streptococcal infections. BMJ. 1993 Feb 13;306(6875):411–412. doi: 10.1136/bmj.306.6875.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Wessels M. R., Kasper D. L. The changing spectrum of group B streptococcal disease. N Engl J Med. 1993 Jun 24;328(25):1843–1844. doi: 10.1056/NEJM199306243282510. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. Yow M. D., Mason E. O., Leeds L. J., Thompson P. K., Clark D. J., Gardner S. E. Ampicillin prevents intrapartum transmission of group B streptococcus. JAMA. 1979 Mar 23;241(12):1245–1247. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES