Rapid detection of group B streptococci in pregnant women at delivery
Rapid detection of group B streptococci in pregnant women at delivery
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DOI：
10.1056/nejm200007203430303
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发表时间：
2000-07-20
影响因子：
158.5
通讯作者：
Fraser, WD
中科院分区：
文献类型：
--
作者：
Bergeron, MG;Ke, DB;Fraser, WD
背景：B族链球菌感染是新生儿发病和死亡的重要原因。一个快速的方法检测这种有机体的孕妇在分娩的时候，需要让新生儿的早期treatmentofnews.Methods：我们研究了两个聚合酶链反应（PCR）检测的有效性常规筛查孕妇组B链球菌在分娩的时候。我们从112名孕妇中获得了肛门、阴道和阴道肛门联合标本;在57名孕妇中，在羊膜破裂前后获得了标本。标本进行了测试，为B组链球菌培养在一个标准的选择性肉汤培养基，与传统的PCR检测，并与一个新的荧光PCR assay.Results：在112名妇女中，合并阴道和肛门标本的培养结果呈阳性的B组链球菌33名妇女（29.5%）。这两种PCR检测方法在33名妇女中的32名的标本中检测到B组链球菌定植：一个阴性PCR结果是在胎膜破裂后获得的样本中。与培养结果比较，两种方法的敏感性均为97.0%，阴性预测值均为98.8%。两种PCR方法的特异性和阳性预测值均为100%。获得结果所需的时间长度为30至45分钟的新的PCR检测，100分钟的常规PCR检测，和至少36小时culture.Conclusions：定植与组B链球菌可以确定快速和可靠的PCR检测孕妇在分娩前后的破膜。（《新英格兰医学杂志》2000;343：175-9）（C）2000年，马萨诸塞州医学会。
Background: Group B streptococcal infections are an important cause of neonatal morbidity and mortality. A rapid method for the detection of this organism in pregnant women at the time of delivery is needed to allow early treatment of neonates.Methods: We studied the efficacy of two polymerase-chain-reaction (PCR) assays for routine screening of pregnant women for group B streptococci at the time of delivery. We obtained anal, vaginal, and combined vaginal and anal specimens from 112 pregnant women; in 57 women, specimens were obtained before and after the rupture of the amniotic membranes. The specimens were tested for group B streptococci by culture in a standard selective broth medium, with a conventional PCR assay, and with a new fluorogenic PCR assay.Results: Among the 112 women, the results of the culture of the combined vaginal and anal specimens were positive for group B streptococci in 33 women (29.5 percent). The two PCR assays detected group B streptococcal colonization in specimens from 32 of these 33 women: the one negative PCR result was in a sample obtained after the rupture of membranes. As compared with the culture results, the sensitivity of both PCR assays was 97.0 percent and the negative predictive value was 98.8 percent. Both the specificity and the positive predictive value of the two PCR assays were 100 percent. The length of time required to obtain results was 30 to 45 minutes for the new PCR assay, 100 minutes for the conventional PCR assay, and at least 36 hours for culture.Conclusions: Colonization with group B streptococci can be identified rapidly and reliably by a PCR assay in pregnant women in labor both before and after the rupture of membranes. (N Engl J Med 2000;343:175-9.) (C)2000, Massachusetts Medical Society.