Money Deborah, Dobson Simon, Cole Lesley, Karacabeyli Eda, Blondel-Hill Edith, Milner Ruth, Thomas Eva
Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of British Columbia, Vancouver BC; Women's Health Research Institute, Children's and Women's Health Centre of British Columbia, Vancouver BC.
Vaccine Evaluation Centre, Children's and Women's Health Centre of British Columbia, Vancouver BC.
J Obstet Gynaecol Can. 2008 Sep;30(9):770-775. doi: 10.1016/S1701-2163(16)32940-1.
To evaluate the sensitivity, specificity, and feasibility of a rapid real-time polymerase chain reaction (PCR) test for group B streptococcus (GBS) completed during labour, compared with the standard culture test performed at 35 to 37 weeks' gestation.
Women presenting to the maternity unit for term vaginal delivery had two vaginal/rectal samples collected. One swab was tested using a rapid PCR method (IDI-Strep B, Infectio Diagnostic [IDI] Inc., Sainte-Foy QC ), and the other was cultured after enrichment (intrapartum culture). Comparisons were made between these results and those of a culture-based screen at 35 to 37 weeks' gestation.
Of the 190 women enrolled, 85% had results of the standard screen at 35 to 37 weeks available for comparison. The sensitivity and specificity of the standard 35- to 37-week screen were 84.3% (95% confidence interval [CI], 71.4-93.0) and 93.2% (95% CI 86.5-97.2) respectively, whereas the sensitivity and specificity of the rapid PCR were 90.7% (95% CI 79.7-96.9) and 97.6% (95% CI 93.1-99.5), respectively. The median reporting time for the rapid PCR test was 99 minutes (range 50-255). Results were available more than four hours before delivery in 81% of cases.
In this Canadian centre, a rapid PCR test done at the time of labour (IDI-Strep B) demonstrated high sensitivity and specificity, comparable to the 35- to 37-week screen. The time to reporting results was acceptably short, allowing for timely administration of intrapartum prophylactic antibiotics.
与妊娠35至37周时进行的标准培养检测相比，评估分娩期间完成的B族链球菌（GBS）快速实时聚合酶链反应（PCR）检测的敏感性、特异性和可行性。
到产科病房准备足月阴道分娩的女性采集两份阴道/直肠样本。一份拭子采用快速PCR方法（IDI - 链球菌B，Infectio Diagnostic [IDI]公司，魁北克省圣福瓦）检测，另一份经富集后培养（产时培养）。将这些结果与妊娠35至37周时基于培养的筛查结果进行比较。
纳入的190名女性中，85%有妊娠35至37周时标准筛查的结果可供比较。标准的35至37周筛查的敏感性和特异性分别为84.3%（95%置信区间[CI]，71.4 - 93.0）和93.2%（95% CI 86.5 - 97.2），而快速PCR的敏感性和特异性分别为90.7%（95% CI 79.7 - 96.9）和97.6%（95% CI 93.1 - 99.5）。快速PCR检测的中位报告时间为99分钟（范围50 - 255分钟）。81%的病例在分娩前4小时以上可获得结果。
在这个加拿大中心，分娩时进行的快速PCR检测（IDI - 链球菌B）显示出高敏感性和特异性，与35至37周的筛查相当。报告结果的时间短得可以接受，能够及时给予产时预防性抗生素。
