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Group B streptococcal PCR testing in comparison to culture for diagnosis of late onset bacteraemia and meningitis in infants aged 7–90 days: a multi-centre diagnostic accuracy study

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Abstract

The aim of this study was to compare an in-house real-time PCR assay, with bacterial culture as the reference, for the diagnosis of late onset group B Streptococcal (GBS) disease. This was a retrospective review. All children aged 7–90 days presenting to four paediatric centres that had a blood or CSF sample tested by GBS PCR were included. Of 7,686 blood and 2,495 cerebrospinal fluid (CSF) samples from patients of all ages received for PCR testing, 893 and 859 samples were eligible for the study, respectively. When compared to culture, the sensitivity of blood PCR was 65% (13/20) in comparison to the CSF PCR test which was 100% (5/5). Ten of 23 PCR-positive blood samples and 17 of 22 PCR-positive CSF samples were culture negative. The median threshold Ct values for culture-positive/PCR-positive CSF samples was lower than that of culture-negative/PCR-positive CSF samples (p = 0.08). Clinical details of 17 available cases that were culture negative/PCR positive were reviewed; seven were deemed to be definite cases, eight were probable and two were possible. The results showed that detection of GBS by PCR is useful for CSF samples from infants aged 7–90 days with suspected meningitis; however, analysis of blood samples by PCR is of limited value as a routine screening test for late onset GBS sepsis and should not replace bacterial culture.

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References

  1. Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB, Hadler JL, Danila R, Cieslak PR, Schuchat A (2000) Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 342(1):15–20

    Article  CAS  PubMed  Google Scholar 

  2. Le Doare K, Heath PT (2013) An overview of global GBS epidemiology. Vaccine 31(Suppl 4):D7–12

    Article  PubMed  Google Scholar 

  3. Okike IO, Johnson AP, Henderson KL, Blackburn RM, Muller-Pebody B, Ladhani SN, Anthony M, Ninis N, Heath PT (2014) Incidence, etiology, and outcome of bacterial meningitis in infants aged <90 days in the United Kingdom and Republic of Ireland: prospective, enhanced, national population-based surveillance. Clin Infect Dis 59(10):e150–157

    Article  PubMed  Google Scholar 

  4. Verani JR, McGee L, Schrag SJ (2010) Prevention of perinatal group B streptococcal disease—revised guidelines from CDC, 2010. MMWR recommendations and reports: morbidity and mortality weekly report recommendations and reports. Ctr Dis Control Prev 59(Rr-10):1–36

    Google Scholar 

  5. Clarke C, O’Connor L, Carre-Skinner H, Piepenburg O, Smith TJ (2016) Development and performance evaluation of a recombinase polymerase amplification assay for the rapid detection of group B streptococcus. BMC Microbiol 16(1):221

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gouvea MI, Joao EC, Teixeira ML, Read JS, Fracalanzza SE, Souza CT, Souza MJ, Torres Filho HM, Leite CC, do Brasil PE (2016) Accuracy of a rapid real-time polymerase chain reaction assay for diagnosis of group B Streptococcus colonization in a cohort of HIV-infected pregnant women. J Matern Fetal Neonatal Med 15:1–6

  7. Fabbrini M, Rigat F, Rinaudo CD, Passalaqua I, Khacheh S, Creti R, Baldassarri L, Carboni F, Anderloni G, Rosini R, Maione D, Grandi G, Telford JL, Margarit I (2016) The Protective value of maternal group B streptococcus antibodies: quantitative and functional analysis of naturally acquired responses to capsular polysaccharides and pilus proteins in European maternal sera. Clin Infect Dis 63(6):746–753

    Article  PubMed  Google Scholar 

  8. Madhi SA, Cutland CL, Jose L, Koen A, Govender N, Wittke F, Olugbosi M, Meulen AS, Baker S, Dull PM, Narasimhan V, Slobod K (2016) Safety and immunogenicity of an investigational maternal trivalent group B streptococcus vaccine in healthy women and their infants: a randomised phase 1b/2 trial. Lancet Infect Dis 16(8):923–934

    Article  CAS  PubMed  Google Scholar 

  9. Mancini N, Carletti S, Ghidoli N, Cichero P, Burioni R, Clementi M (2010) The era of molecular and other non-culture-based methods in diagnosis of sepsis. Clin Microbiol Rev 23(1):235–251

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Pammi M, Flores A, Leeflang M, Versalovic J (2011) Molecular assays in the diagnosis of neonatal sepsis: a systematic review and meta-analysis. Pediatrics 128(4):e973–985

    Article  PubMed  Google Scholar 

  11. de Zoysa A, Edwards K, Gharbia S, Underwood A, Charlett A, Efstratiou A (2012) Non-culture detection of Streptococcus agalactiae (Lancefield group B Streptococcus) in clinical samples by real-time PCR. J Med Microbiol 61(Pt 8):1086–1090

    Article  PubMed  Google Scholar 

  12. Favaro M, Savini V, Favalli C, Fontana C (2013) A multi-target real-time PCR assay for rapid identification of meningitis-associated microorganisms. Mol Biotechnol 53(1):74–79

    Article  CAS  PubMed  Google Scholar 

  13. Meehan M, Cafferkey M, Corcoran S, Foran A, Hapnes N, LeBlanc D, McGuinness C, Nusgen U, O’Sullivan N, Cunney R, Drew R (2015) Real-time polymerase chain reaction and culture in the diagnosis of invasive group B streptococcal disease in infants: a retrospective study. Eur J Clin Microbiol Infect Dis 34(12):2413–2420

    Article  CAS  PubMed  Google Scholar 

  14. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, Lijmer JG, Moher D, Rennie D, de Vet HC, Kressel HY, Rifai N, Golub RM, Altman DG, Hooft L, Korevaar DA, Cohen JF (2015) STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 351:h5527

    Article  PubMed  PubMed Central  Google Scholar 

  15. Burke RM, McKenna JP, Cox C, Coyle PV, Shields MD, Fairley DJ (2016) A comparison of different pre-lysis methods and extraction kits for recovery of Streptococcus agalacticae (Lancefield group B Streptococcus) DNA from whole blood. J Microbiol Methods 129:103–108

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the staff of the involved laboratories for their assistance with the project; Children’s University Hospital Temple Street, Our Lady of Lourdes Hospital Drogheda, University Hospital Waterford and Our Lady’s Hospital, Crumlin.

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Authors and Affiliations

  1. Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children’s University Hospital, Dublin 1, Ireland

    S. M. Morrissey, M. Nielsen, M. Meehan, N. O’Sullivan, R. Cunney & R. J. Drew

  2. Department of Microbiology, University Hospital Waterford, Co. Waterford, Ireland

    L. Ryan & M. Doyle

  3. Departments of Microbiology and Paediatric Infectious Diseases, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland

    H. Al Dhanhani, P. Gavin & N. O’Sullivan

  4. Department of Microbiology, Our Lady’s Hospital, Co. Louth, Drogheda, Ireland

    S. McDermott

  5. Department of Microbiology, Rotunda Hospital, Dublin 1, Ireland

    R. J. Drew

  6. Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin 2, Ireland

    R. J. Drew

  7. Rotunda Hospital, Parnell Square, Dublin 1, Ireland

    R. J. Drew

Authors
  1. S. M. Morrissey
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  2. M. Nielsen
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  3. L. Ryan
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  4. H. Al Dhanhani
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  5. M. Meehan
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  6. S. McDermott
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  7. N. O’Sullivan
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  8. M. Doyle
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  9. P. Gavin
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  10. N. O’Sullivan
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  11. R. Cunney
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  12. R. J. Drew
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Corresponding author

Correspondence to R. J. Drew.

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Funding

No funding was received for this project

Conflict of Interest

The authors declare that they have no conflict of interest

Ethical approval

This study was approved by the Ethics Committee of the Children’s University Hospital, Temple Street (Approval 15.045).

Informed consent

Consent was not taken from patients as this was a retrospective review, with no patient interventions.

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Cite this article

Morrissey, S.M., Nielsen, M., Ryan, L. et al. Group B streptococcal PCR testing in comparison to culture for diagnosis of late onset bacteraemia and meningitis in infants aged 7–90 days: a multi-centre diagnostic accuracy study. Eur J Clin Microbiol Infect Dis 36, 1317–1324 (2017). https://doi.org/10.1007/s10096-017-2938-3

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  • DOI: https://doi.org/10.1007/s10096-017-2938-3

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