Application of Real-time PCR to Identify Carriers of Group B Streptococci (GBS) in Pregnant Women

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Other Title
  • 妊婦におけるB 群溶血性レンサ球菌（GBS）の保菌検査への real-time PCR 法の応用
  • ニンプ ニ オケル Bグン ヨウケツセイ レンサ キュウキン(GBS)ノ ホキン ケンサ エ ノ real-time PCRホウ ノ オウヨウ

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<p>Background and Objective：Streptococcus agalactiae (group B streptococcus, GBS) is one of the important pathogens of invasive neonatal infections that results frequently in a poor prognosis in cases following onset. The polysaccharide capsule present on the GBS surface is a key pathogenic factor and the majority of the cases originate from serotypes Ia, Ib, or III. The GBS infection in neonates arises mostly during the delivery through the birth canal. For this reason, GBS colonization screening of mothers is already conducted routinely for late pregnancy in Japan. However, cultivation tests require several days without the serotype identification until the results are reported. We therefore applied the “Cycleave PCR GBS Detection Kit” and “GBS Capsular Typing Kit” that were constructed as research reagents to identify GBS and its capsular serotype, on samples obtained from pregnant women；these results were compared with those of the culture.<BR>Subjects and Methods：We investigated vaginal/anal swab samples collected from late pregnancy who were asked to participate in the study at multiple maternity hospitals. The 500 samples were collected during the 4-month period starting July 1, 2017. Cultivation tests were carried out as routine laboratory work and another PCR was performed in accordance with the manufacturersʼ protocols. GBS serotypes identified by the PCR were Ia, Ib, and III.<BR>Results：The number of GBS-positive samples were 84 (16.8%) with PCR and 76 (15.2%) with culture. Of those samples, ten were positive with PCR but negative with culture. The PCR method was superior with a sensitivity of 97.4% and specificity of 97.6%. Of the 74 samples that were positive according to both methods,56.8% were serotyped with PCR (Ia [n=9], Ib [n=12], and III [n=21]), but 47.3% were serotyped into these three types with the serum agglutination method. The required time from initiation of PCR testing to report of results was 2.5 hours.<BR>Conclusion：GBS identification and the serotyping with PCR was clearly superior compared with the culture method from the perspective of sensitivity, specificity, and rapidity. Application of the PCR method described here for GBS screening in pregnant women and the neonates will be highly useful in the clinical setting.</p>

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 93 (4), 507-514, 2019-07-20

    The Japanese Association for Infectious Diseases

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