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Clinical value of polymerase chain reaction in detecting group B streptococcus during labor
Author(s) -
Koppes Dorothea Maria,
Vriends Antonius Arnoldus Cornelis Maria,
Rijn Michiel,
Heesewijk Antonine Dimphne
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13321
Subject(s) - medicine , prom , antibiotics , group b , polymerase chain reaction , obstetrics , gynecology , microbiology and biotechnology , biology , biochemistry , gene
Aim To reduce the intrapartum use of antibiotics in women with prolonged rupture of the membranes (PROM) by restriction of antibiotics to women who are colonized with group B streptococci (GBS), as identified with the Cepheid Gene Xpert polymerase chain reaction (PCR) for detecting GBS. Methods We conducted a randomized controlled trial among full‐term delivering women with PROM. Fifty‐four women were enrolled, based on a power calculation with a significance level of 5% and a power of 95%. Twenty‐seven women received the standard treatment (rectovaginal swab [RVS] for bacterial culture and antibiotics). For another 27 women PCR was performed on the RVS and antibiotics were used only when the PCR was positive. The primary outcome was reduction in antibiotic use, defined as the percentage of women who received antibiotics during labor. Results 54 Women were enrolled in the study between 1 May and 18 November 2014. There were no significant differences in baseline characteristics. In total, 10 of the 54 women were GBS positive (18.5%). Of those 10 women, three were identified on bacterial culture and seven on PCR. In the bacterial culture group all the women received antibiotics. In the PCR group 10 women (37%) received antibiotics ( P = 0.002). Two false‐positive PCR tests were identified. There were no false‐negative PCR tests. Conclusion Real‐time identification of GBS on PCR reduces the intrapartum use of antibiotics in women with PROM.