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产时聚合酶链反应检测是一种用于孕期B族链球菌检测的快速高效筛查方法。

Intrapartum PCR assay is a fast and efficient screening method for Group B Streptococcus detection in pregnancy.

作者信息

Zietek Maciej, Jaroszewicz-Trzaska Joanna, Szczuko Malgorzata, Mantiuk Radoslaw, Celewicz Zbigniew

机构信息

Department of Perinatology, Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland.

Department of Human Nutrition and Metabolomics, Pomeranian Medical University, Szczecin, Poland.

出版信息

Ginekol Pol. 2020;91(9):549-553. doi: 10.5603/GP.2020.0088.

Abstract

OBJECTIVES

The aim of the study is to verify the usefulness of a real-time polymerase chain reaction versus the culture for ante- and intrapartum group B Streptococcus maternal colonization (GBS) and prevalence of discordance during the period between an antepartum screening and delivery.

MATERIAL AND METHODS

The study involved 106 pregnant women aged 18 to 39 years. Rectovaginal samples were collected according to CDC guidelines at 35-37 weeks of gestation as well as in the first stage of labour, during physical examination and were analyzed using two independent diagnostic methods: microbiological culture with standard culture and polymerase chain reaction with real-time assay.

RESULTS

The discordance between antenatal and intrapartum GBS prevalence has been demonstrated as well as differences associated with diagnostic strategies, culture and PCR.

CONCLUSIONS

Intrapartum detection of GBS colonization using culture or Real-Time PCR assay as well, regardless of antenatal screening test for GBS, is very useful in identifying women who require implementation or withdrawal from prophylactic intrapartum antibiotic therapy. Real-Time PCR is a quick efficient method for GBS screening in pregnant women, which can be even applied during labor due to its short time of analyzing and high sensitivity and specificity. The above fact may indicate the need to perform the GBS test in the intrapartum period in all pregnant GBS negative women using PCR assay as a more adequate diagnostic method as the procedure could reduce the risk of a neonatal GBS infection subsequently to a prophylactic antibiotic therapy in women with an intrapartum positive GBS.

摘要

目的

本研究旨在验证实时聚合酶链反应与培养法在产前和产时B族链球菌(GBS)母体定植检测中的实用性,以及产前筛查与分娩期间不一致情况的发生率。

材料与方法

该研究纳入了106名年龄在18至39岁之间的孕妇。按照美国疾病控制与预防中心(CDC)的指南,在妊娠35 - 37周以及分娩第一阶段进行体格检查时采集直肠阴道样本,并使用两种独立的诊断方法进行分析:标准培养的微生物培养法和实时检测的聚合酶链反应法。

结果

已证实产前和产时GBS定植率之间存在不一致情况,以及与诊断策略、培养法和聚合酶链反应相关的差异。

结论

无论产前GBS筛查结果如何,使用培养法或实时聚合酶链反应法进行产时GBS定植检测,对于识别需要实施或停止预防性产时抗生素治疗的女性非常有用。实时聚合酶链反应是一种快速有效的孕妇GBS筛查方法,由于其分析时间短、灵敏度和特异性高,甚至可在分娩期间应用。上述事实可能表明,对于所有产前GBS检测阴性的孕妇,在产时使用聚合酶链反应法作为更合适的诊断方法进行GBS检测是有必要的,因为该程序可以降低产时GBS阳性女性接受预防性抗生素治疗后新生儿GBS感染的风险。

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