Application of the appropriate molecular biology-based method significantly increases the sensitivity of group B streptococcus detection results

Background: Streptococcus agalactiae (group B streptococcus: GBS) is a leading cause of early-and late-onset diseases in neonates. Reliable results of GBS carriage investigation among pregnant women may decrease the incidence of neonatal infection and mortality. Aim: To compare the results of conventional culture investigation with those of the US Food and Drug Administration-approved nucleic acid amplification test (BD Max GBS (Becton Dickinson)), and to establish our own protocols of standard polymerase chain reaction (PCR). Methods: A total of 250 vaginal-rectal swabs from three different hospitals in Bydgoszcz, Poland, were used to evaluate GBS carriage. Standard laboratory technique (overnight culture in broth enrichment media) results were compared with those of BD Max GBS assay (Becton Dickinson) and two standard PCR protocols, established to detect the cfb and 16S rRNA S. agalactiae genes, from the overnight cultures of the samples in the liquid enrichment media. Findings: The overall GBS carriage was estimated as 16.4-23.2%, depending on the applied detection method. The highest percentage of positive results, from each laboratory was obtained with the application of BD Max GBS assay. The differences in the number of positive results obtained with this particular method were statistically significant. Overall, 27 discrepancies were noted for the results obtained with the application of the methods compared. Conclusions: The methods applied for GBS detection differ in sensitivity. A culture technique, though very specific, appears to be less sensitive at detecting S. agalactiae compared with the commercially available BD Max GBS assay or in-house PCR protocols established for this purpose. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study compared the results of conventional culture investigation, BD Max GBS assay, and standard PCR protocols for detecting GBS carriage among pregnant women. The BD Max GBS assay had the highest percentage of positive results, showing statistically significant differences compared to other methods.