在丹麦队列中,采用产时聚合酶链反应(PCR)检测与产前培养评估出生时B族链球菌的阴道携带情况

Intrapartum PCR assay versus antepartum culture for assessment of vaginal carriage of group B streptococci in a Danish cohort at birth.

作者信息

Khalil Mohammed Rohi, Uldbjerg Niels, Thorsen Poul Bak, Møller Jens Kjølseth

机构信息

Department of Gynecology and Obstetrics, Lillebaelt Hospital, Kolding, Denmark.

Department of Obstetrics and Gynecology, Aarhus University hospital, Skejby, Denmark.

出版信息

PLoS One. 2017 Jul 5;12(7):e0180262. doi: 10.1371/journal.pone.0180262. eCollection 2017.

Abstract

The aim of this study was to compare the performances of two strategies for predicting intrapartum vaginal carriage of group B streptococci (GBS). One strategy was based on an antepartum culture and the other on an intrapartum polymerase chain reaction (PCR). We conducted a prospective observational study enrolling 902 pregnant women offered GBS screening before delivery by two strategies. The Culture-strategy was based on vaginal and rectal cultures at 35-37 weeks' gestation, whereas the PCR-strategy was based on PCR assay on intrapartum vaginal swab samples. An intrapartum vaginal culture for GBS was used as the reference standard from which the performances of the 2 strategies were evaluated. The reference standard showed a GBS-prevalence of 12%. The culture-strategy performed with a sensitivity of 82%, specificity of 91%, positive predictive value (PPV) of 55%, negative predictive value (NPV) of 98%, and Likelihood ratio (LH+) of 9.2. The PCR-strategy showed corresponding values as sensitivity of 83%, specificity of 97%, PPV of 78%, NPV of 98%, and LH+ of 27.5. We conclude that in a Danish population with a low rate of early-onset neonatal infection with GBS, the intrapartum PCR assay performs better than the antepartum culture for identification of GBS vaginal carriers during labor.

摘要

本研究的目的是比较两种预测产时B族链球菌(GBS)阴道携带情况的策略的性能。一种策略基于产前培养,另一种基于产时聚合酶链反应(PCR)。我们进行了一项前瞻性观察性研究,纳入了902名在分娩前通过两种策略进行GBS筛查的孕妇。培养策略基于妊娠35 - 37周时的阴道和直肠培养,而PCR策略基于产时阴道拭子样本的PCR检测。GBS的产时阴道培养用作评估这两种策略性能的参考标准。参考标准显示GBS患病率为12%。培养策略的敏感性为82%,特异性为91%,阳性预测值(PPV)为55%,阴性预测值(NPV)为98%,似然比(LH+)为9.2。PCR策略的相应值为敏感性83%,特异性97%,PPV为78%,NPV为98%,LH+为27.5。我们得出结论,在丹麦早发性新生儿GBS感染率较低的人群中,产时PCR检测在识别分娩期间GBS阴道携带者方面比产前培养表现更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5aa3/5497980/5211432e9d0c/pone.0180262.g001.jpg

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