From the Department of Obstetrics and Gynecology, Riverside Methodist Hospital, and OhioHealth Research & Innovation Institute, Columbus, Ohio.
Obstet Gynecol. 2011 Aug;118(2 Pt 1):313-317. doi: 10.1097/AOG.0b013e318225383b.
To estimate whether vaginal-perianal cultures could be an alternative to the recommended vaginal-rectal screening cultures for the detection of group B streptococci (GBS) during pregnancy, and to compare patient pain and discomfort between the two collection methods.
Patients included were aged 18 or older and at 35-37 weeks of gestation. After consent, each patient underwent collection of a vaginal-perianal followed by a vaginal-rectal culture. Patients rated their pain on a 0-to-10 scale for each collection method and indicated whether one method had more discomfort than the other. The primary outcome of the study was the proportion of patients whose vaginal-perianal and vaginal-rectal culture results agreed with one another.
Data were collected from 193 patients. The overall agreement rate between the vaginal-perianal and vaginal-rectal cultures was 186 out of 193 (96.4%; lower 95% confidence bound was 93.4%), yielding a 91.1% sensitivity and 98.5% specificity. There were two false positives and five false negatives. The GBS detection rates were similar between the two collection methods (P = .257). On average, pain was 3.4 points for the vaginal-rectal method and 1.2 points for the vaginal-perianal method (P<.001). More than two-thirds of the patients stated that the vaginal-perianal collection method had less discomfort than the vaginal-rectal method.
Agreement was high between the recommended vaginal-rectal and the studied vaginal-perianal collection methods. Patients indicated less pain and discomfort with the vaginal-perianal collection method. Therefore, vaginal-perianal cultures may be reasonable, patient-preferred alternatives for the recommended vaginal-rectal cultures for detection of GBS during pregnancy.
II.
评估阴道-肛门培养是否可以替代推荐的阴道-直肠筛查培养，以检测妊娠期间的 B 组链球菌（GBS），并比较两种采集方法的患者疼痛和不适。
纳入的患者年龄为 18 岁或以上，孕周为 35-37 周。征得同意后，每位患者均采集阴道-肛门和阴道-直肠培养物。患者对两种采集方法的疼痛程度进行 0 到 10 分的评分，并指出一种方法是否比另一种方法更不适。本研究的主要结局是阴道-肛门和阴道-直肠培养结果一致的患者比例。
共收集了 193 例患者的数据。阴道-肛门和阴道-直肠培养的总体一致率为 193 例中的 186 例（96.4%；置信下限为 93.4%），敏感性为 91.1%，特异性为 98.5%。有两个假阳性和五个假阴性。两种采集方法的 GBS 检出率相似（P =.257）。平均而言，阴道-直肠法的疼痛为 3.4 分，阴道-肛门法为 1.2 分（P<.001）。超过三分之二的患者表示，阴道-肛门采集法的不适感小于阴道-直肠法。
推荐的阴道-直肠和研究的阴道-肛门采集方法之间的一致性很高。患者表示阴道-肛门采集法的疼痛和不适感较轻。因此，阴道-肛门培养可能是合理的、患者更喜欢的替代推荐的阴道-直肠培养，以检测妊娠期间的 GBS。
II。
