Impact of combined vaginal group B Streptococcus screening (culture and rapid PCR) in pregnant women on neonatal morbidity and mortality

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-06-26 DOI:10.1016/j.jiph.2025.102883

Maëlig Abgral , Léonie Albersammer , Julie Carrara , Christelle Guillet-Caruba , Alexandra Benachi , Daniele De Luca , Rafik Ben Ammar , Nadège Bourgeois-Nicolaos , Alexandre J. Vivanti

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Abstract

Background

Vaginal colonization by group B Streptococcus (GBS) in pregnant women is a major risk factor for early-onset neonatal infection, by vertical transmission during birth. Current guidelines recommend universal screening via vaginal swab and culture in the third trimester for antibiotic prophylaxis. Since 2013, the Antoine Béclère maternity hospital has offered combined screening for GBS carriage using culture at the third trimester and PCR on vaginal swabs in the delivery room. The primary aim was to assess the added value of PCR in culture-negative or unscreened women.

Methods

This observational, retrospective, single-center study involved full-term deliveries between Jan 1, 2015, and Dec 31, 2020, in a type III perinatal unit (Clamart, France). All women at 35–38 weeks’ gestation (WG) were offered vaginal culture screening. PCR was performed in the delivery room if culture was negative or not done.

Results

15,013 patients gave birth to 15,337 newborns ≥37 WG; 14,863 women (99.0 %) were screened. Among 11,415 women with vaginal culture, 1416 (12.4 %) were positive. 3448 (23.0 %) were not screened by culture. PCR at birth identified 621 additional GBS cases (4.1 %): 327 (2.2 %) in unscreened women and 294 (1.9 %) with prior negative culture. No neonatal GBS infections were observed. There were 4 cases (0.02 %) of postpartum endometritis.

Conclusion

Intrapartum PCR identified 2.2 % additional cases in unscreened women and 1.9 % missed after prior negative culture. This rapid and effective method appears feasible for routine use.

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孕妇阴道联合B群链球菌筛查（培养和快速PCR）对新生儿发病率和死亡率的影响

背景：孕妇阴道内B群链球菌（GBS）的定植是新生儿早发性感染的主要危险因素，在分娩过程中通过垂直传播。目前的指南建议在妊娠晚期通过阴道拭子和培养进行普遍筛查，以预防抗生素。自2013年以来，Antoine bcl妇产医院利用妊娠晚期培养和产房阴道拭子PCR对吉兰-巴雷综合征进行联合筛查。主要目的是评估PCR在培养阴性或未筛查妇女中的附加价值。方法：本观察性、回顾性、单中心研究涉及2015年1月1日至2020年12月31日期间在一家III型围产病房（法国Clamart）分娩的足月产妇。所有妊娠35-38周（WG）的妇女进行阴道培养筛查。如果培养阴性或未做，在产房进行PCR。结果15013例患者生育≥37 WG新生儿15337例；14863名妇女（99.0 %）接受了筛查。在11415例阴道培养中，1416例（12.4 %）阳性。3448例（23.0 %）未通过培养筛选。出生时PCR鉴定出621例GBS病例（4.1 %）：327例（2.2 %）未筛查妇女，294例（1.9 %）既往培养阴性。未观察到新生儿GBS感染。产后子宫内膜炎4例（0.02 %）。结论产时PCR检测出2.2 %未筛查妇女的额外病例，1.9 %先前阴性培养的妇女漏诊。这种快速有效的方法在日常应用中是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.