Clinical impact of rapid polymerase chain reaction (PCR) test for group B Streptococcus (GBS) in term women with ruptured membranes
Early-onset group B Streptococcus (EOGBS/GBS) infection remains a significant cause of neonatal morbidity and mortality.
Aiming to improve antimicrobial stewardship and reduce unnecessary maternal and infant exposure to intrapartum antibiotic prophylaxis (IAP), this study assessed the clinical use of a commercially available GBS polymerase chain reaction (PCR) assay for term women with pre-labour rupture of membranes.
This was a retrospective study in a tertiary level maternity unit of term women with pre-labour rupture of membranes (ROM), without any clinical suspicion of infection performed between November and December 2017. GBS PCR tests were cross-referenced with patient clinical data. PCR test results, the impact of testing on antibiotic administration, pyrexia in labour, induction, interventional delivery rates and neonatal outcomes were analysed.
Of 200 patients included in the study, 29 were positive (14.5%) and 166 were negative (83%), with five invalid results (2.5%). One hundred and twenty three women had > 18-h ruptured membranes and 86 women (70%) who would have been eligible for IAP based on risk factors avoided antibiotic therapy following a negative PCR test. There were no significant differences in induction or interventional delivery rates between GBS-positive and GBS-negative women following PCR testing. During the study period, there were no cases of EOGBS.
In a centre adhering to a risk-factor-based GBS policy, the introduction of limited rapid GBS screening for term women with pre-labour rupture of membranes resulted in a clinically significant reduction in prophylactic antibiotic use.
KeywordsGBS GeneXpert® PCR Term pre-labour ROM
The authors wish to acknowledge the staff of the National Maternity Hospital and the women attending the hospital.
All four authors meet all the criteria for authorship.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Heath P, Jardine L (2014) Neonatal infections: group B Streptococcus. BMJ Clin Evid Online 2014:323Google Scholar
- 7.Health Service Executive (2017) Epidemiology of invasive group B streptococcal infections in Ireland, 2016. Health Service ExecutiveHealth Protection Surveillance Centre. http://www.hpsc.ie/az/other/groupbstreptococcaldisease/publications/annualreports/iGBS%20Surveillance%202016%20FINAL.pdf. Accessed 9 Oct 2018
- 15.Perlitz Y, Ben-Ami M, Megory E, Nitzan O, Bouganim T, Younis J et al (2018) A comparison of enriched culture and Xpert polymerase chain reaction assay of group B Streptococcus carrier status at 35–37-week gestation to labor onset: a prospective controlled study. J Matern Fetal Neonatal Med 31:2170–2174CrossRefGoogle Scholar
- 16.Poncelet-Jasserand E, Forges F, Varlet M, Chauleur C, Seffert P, Siani C et al (2013) Reduction of the use of antimicrobial drugs following the rapid detection of Streptococcus agalactiae in the vagina at delivery by real-time PCR assay. BJOG Int J Obstet Gynaecol 120(9):1098–1109CrossRefGoogle Scholar