Risk-based screening combined with a PCR-based test for group B streptococci diminishes the use of antibiotics in laboring women

Mohammad Khalil, Niels Uldbjerg, Poul Bak Thorsen, Birgitte Henriksen, Jens K Møller

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

OBJECTIVE: To assess the performance of a polymerase chain reaction - group B streptococci test (PCR-GBS test) - in deciding antibiotic prophylaxis in term laboring women.

STUDY DESIGN: In this observational study, we enrolled 902 unselected Danish term pregnant women. During labor, midwives obtained vaginal swabs that were used for both GBS cultures (reference standard) and for the PCR-GBS test. Furthermore, we recorded the presence of risk factors for EOGBS (Early Onset Group B Streptococcal disease): (1) Bacteriuria during current pregnancy, (2) Prior infant with EOGBS (3) Temperature above 38.0°C during labor, and (4) Rupture of membranes ≥18h.

RESULTS: The prevalence of GBS carriers was 12% (104 of 902), the sensitivity of the PCR-GBS test 83% (86 of 104), and the specificity 97% (774 of 798). Among the 108 with one or more EOGBS-risk factors, GBS was present in 23% (25 of 108), the sensitivity 92% (23 of 25), and the specificity 89% (74 of 83).

CONCLUSION: In programs that aim to treat all laboring women with vaginal GBS-colonization (12% in the present study) with penicillin, the PCR-GBS will perform well (sensitivity 83% and specificity 97%). In programs aiming to treat only GBS-carriers among those with risk factors of EOGBS, a reduction of penicillin usage by two-thirds from 12% to 4% may be possible.

Original languageEnglish
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Volume215
Pages (from-to)188-192
ISSN0301-2115
DOIs
Publication statusPublished - 2017

Keywords

  • Journal Article

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