Real-time PCR-assay in the delivery suite for determination of group B streptococcal colonization in a setting with risk-based antibiotic prophylaxis.
J Matern Fetal Neonatal Med
; 27(4): 328-32, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-23795754
ABSTRACT
OBJECTIVE:
Intrapartum antibiotic prophylaxis (IAP) reduces the incidence of neonatal early onset group B streptococcal infections. The present study investigated if an automated PCR-assay, used bedside by the labor ward personnel was manageable and could decrease the use of IAP in a setting with a risk-based IAP strategy.METHODS:
The study comprises two phases. Phase 1 was a multicenter, randomized, controlled trial. Women with selected risk-factors were allocated either to PCR-IAP (prophylaxis given if positive or indeterminate) or IAP. A vaginal/rectal swab and superficial swabs from the neonate for conventional culture were also obtained. Phase 2 was non-randomized, assessing an improved version of the assay.RESULTS:
Phase 1 included 112 women in the PCR-IAP group and 117 in the IAP group. Excluding indeterminate results, the assay showed a sensitivity of 89% and a specificity of 90%. In 44 % of the PCR assays the result was indeterminate. The use of IAP was lower in the PCR group (53 versus 92%). Phase 2 included 94 women. The proportion of indeterminate results was reduced (15%). The GBS colonization rate was 31%.CONCLUSION:
The PCR assay, in the hands of labor ward personnel, can be useful for selection of women to which IAP should be offered.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções Estreptocócicas
/
Streptococcus agalactiae
/
DNA Bacteriano
/
Assistência Perinatal
/
Transmissão Vertical de Doenças Infecciosas
/
Antibioticoprofilaxia
/
Reação em Cadeia da Polimerase em Tempo Real
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
J Matern Fetal Neonatal Med
Assunto da revista:
OBSTETRICIA
/
PERINATOLOGIA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Suécia