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Journal of Clinical Microbiology, March 2006, p. 725-728, Vol. 44, No. 3
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.3.725-728.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Sensitivities of Antigen Detection and PCR Assays Greatly Increased Compared to That of the Standard Culture Method for Screening for Group B Streptococcus Carriage in Pregnant Women

Fabien Rallu,* Peter Barriga, Carole Scrivo, Valérie Martel-Laferrière, and Céline Laferrière

Département de Microbiologie, CHU Sainte-Justine, Montréal, PQ, Canada

Received 30 November 2005/ Returned for modification 7 December 2005/ Accepted 9 December 2005

Group B streptococcus (GBS) is a major cause of serious infections in neonates. The 2002 revised guidelines of the Centers for Disease Control and Prevention (CDC) for the prevention of perinatal GBS disease recommend that all pregnant women be screened for GBS carriage at between 35 and 37 weeks of gestation and that intrapartum antibiotic prophylaxis be given to carriers. We studied the performances of four different GBS detection assays in the context of antenatal screening. Between May and August 2004, the 605 vaginorectal swab specimens received at our bacteriology laboratory for GBS antenatal detection were tested by the four assays. The standard culture method was done according to the CDC recommendations. The three experimental assays performed with the growth from the selective enrichment (LIM) broth (Todd-Hewitt broth with 15 µg/ml nalidixic acid and 10 µg/ml colistin) after overnight incubation were a GBS antigen detection assay (PathoDx) and two PCR assays (for cfb and scpB). The most accurate assay was the scpB PCR (sensitivity, 99.6%; specificity, 100%), followed by the cfb PCR (sensitivity, 75.3%; specificity, 100%), GBS antigen detection (sensitivity, 57.3%; specificity, 99.5%), and standard culture (sensitivity, 42.3%; specificity, 100%). The GBS antigen detection assay was found to be more sensitive than the standard culture method, and moreover, the assay has a low cost and is easy to perform in all obstetrical centers which have access to the most basic of diagnostic microbiology services. We believe that antigen detection on incubated LIM broth should replace the standard culture method for screening for GBS carriage at 35 to 37 weeks of gestation. The impact of the greater sensitivities of PCR assays on the diminution of neonatal GBS infections remains to be demonstrated.

* Corresponding author. Mailing address: Département de Microbiologie, CHU Sainte Justine, 3175 Côte Sainte Catherine, Montréal, Québec H3T 1C5, Canada. Phone: (514) 345-4931, ext. 6005. Fax: (514) 345-4860. E-mail: fabien.rallu.hsj{at}ssss.gouv.qc.ca.

Journal of Clinical Microbiology, March 2006, p. 725-728, Vol. 44, No. 3
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.3.725-728.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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