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Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

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Abstract

Group B streptococci (GBS) are a leading cause of infectious neonatal morbidity and mortality. Timely and accurate identification of colonized pregnant women is imperative to implement intrapartum antibioprophylaxis (IAP) to reduce the risk of early neonatal sepsis. Current guidelines recommend screening for GBS carriage with vaginal-rectal cultures. However, cultures require 24–72 h, thus precluding their use for intrapartum screening and these are only performed at 35–37 weeks gestation. New rapid molecular-based tests can detect GBS within hours. They have the potential to be used intrapartum and to allow for selective IAP in women carrying GBS. An advantage is that they can sometimes be performed by non-laboratory staff in the labor suite, thus avoiding delays in sample transfers to the microbiology laboratory. Another possible use of molecular-based assays is for the diagnosis of neonatal sepsis, where tests with a short turnaround time and high sensitivity and specificity are crucial. In this situation, the detection of microorganisms once antibiotic therapy has already been started is important, as treatment is started immediately once sepsis is suspected without waiting for microbiological confirmation. In this article, we discuss the state-of-the-art molecular-based tests available for GBS screening during pregnancy, as well as their implications for IAP for the diagnosis and prevention of neonatal sepsis.

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Acknowledgments

We thank Mrs Sudan for her editing work. JS and BMT have received an unrestricted grant from Cepheid Inc. None of the authors have any conflicts of interest with this study, which has not been funded.

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Authors and Affiliations

  1. Department of Genetics and Laboratory Medicine, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland

    Stéphane Emonet & Jacques Schrenzel

  2. Department of Internal Medicine, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland

    Stéphane Emonet & Jacques Schrenzel

  3. Department of Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, 30 Boulevard de la Cluse Geneva, 1211, Geneva 14, Switzerland

    Begoña Martinez de Tejada

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  1. Stéphane Emonet
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Correspondence to Begoña Martinez de Tejada.

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Emonet, S., Schrenzel, J. & Martinez de Tejada, B. Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy. Mol Diagn Ther 17, 355–361 (2013). https://doi.org/10.1007/s40291-013-0047-2

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