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Tanno D, Saito K, Tomii Y, Nakatsuka Y, Uechi K, Ohashi K, Hidaka T, Yamadera Y, Hata A, Toyokawa M, Shimura H. A Multicenter Study on the Utility of Selective Enrichment Broth for Detection of Group B Streptococcus in Pregnant Women in Japan. Jpn J Infect Dis 2024; 77:68-74. [PMID: 37914290 DOI: 10.7883/yoken.jjid.2023.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Universal screening for Streptococcus agalactiae, Group B Streptococcus (GBS), in pregnant women is important for the prevention of severe infectious diseases in neonates. The subculture method using selective enrichment broth significantly improves GBS detection rates in the United States; however, this method is not widely utilized in Japan mainly because of the lack of large-scale validation. Therefore, we aimed to validate the utility of the subculture method in collaboration with multiple facilities. A total of 1957 vaginal-rectal swab specimens were obtained from pregnant women at 35-37 gestational weeks from March 1, 2020, to August 30, 2020, at Fukushima Medical University Hospital, Aiiku Hospital, Kitano Hospital, and the University of the Ryukyus Hospital. Conventional direct agar plating, subculture using selective enrichment broth, and direct latex agglutination (LA) testing with incubated broth were performed for GBS detection, and discrepant results were confirmed using real-time PCR. The GBS detection rates for direct agar plating, subculture, and direct LA testing were 18.2% (357/1957), 21.6% (423/1957), and 22.3% (437/1957), respectively. The use of selective enrichment broth showed promise for GBS detection with high sensitivity and is therefore recommended for GBS screening to prevent GBS-related infectious diseases in neonates in Japan.
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Affiliation(s)
- Daiki Tanno
- Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University, Japan
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Japan
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Kyoichi Saito
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Japan
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yasuaki Tomii
- Department of Clinical Laboratory, Aiiku Hospital, Japan
| | - Yukari Nakatsuka
- Department of Laboratory Medicine, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-kofukai, Japan
| | - Kohei Uechi
- Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Japan
| | - Kazutaka Ohashi
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Japan
| | - Tomoo Hidaka
- Department of Hygiene and Preventive Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Yukio Yamadera
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Japan
| | - Atsuko Hata
- Department of Pediatrics, Division of Infectious Diseases, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-kofukai, Japan
| | - Masahiro Toyokawa
- Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University, Japan
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Japan
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Japan
| | - Hiroki Shimura
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Japan
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Japan
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Tanno D, Saito K, Ohashi K, Toyokawa M, Yamadera Y, Shimura H. Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry with Time-of-Flight Peak Analysis for Rapid and Accurate Detection of Group B Streptococcus in Pregnant Women. Microbiol Spectr 2022; 10:e0173221. [PMID: 35435738 PMCID: PMC9241660 DOI: 10.1128/spectrum.01732-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/30/2022] [Indexed: 11/20/2022] Open
Abstract
Severe infections in neonates caused by Streptococcus agalactiae, Group B Streptococcus (GBS), are often associated with GBS transmission from their mothers during labor or birth. Hence, it is necessary to develop a universal method for screening vaginal-rectal GBS colonization in pregnant women worldwide. A subculture of vaginal-rectal swabs using a selective enrichment broth and an agar plate is conventionally recommended for GBS screening. However, infants born to mothers who are GBS negative on subculture sometimes contract GBS infections. Therefore, we developed another method with high sensitivity for GBS screening. A total of 178 vaginal-rectal swabs from pregnant women were inoculated into the enrichment broth, of which 126 were suspected of containing GBS due to the change in the color of the broth. The subculture results were positive for GBS in 34 (27.0%) swabs. Each broth was then analyzed using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Analysis of the TOF peaks specific to GBS revealed 45 (35.7%) swabs as GBS positive. Of the 11 GBS positive samples on TOF peak analysis but negative on subculture, S. agalactiae gene targets were detected through PCR in 4 samples. MALDI detection with analysis of peaks of TOF (MDAPT) can detect GBS directly from cultured broth with high sensitivity. MDAPT can be an alternative method for GBS screening in pregnant women and contribute to the prevention of severe GBS infectious diseases in neonates. IMPORTANCE As previously reported, 10%-30% of pregnant women carry Streptococcus agalactiae, Group B Streptococcus (GBS), in their vagina or rectum, and approximately 50% of them vertically transmit GBS to their neonates during labor or birth. Moreover, 1%-2% of the GBS-transmitted neonates develop severe GBS infectious diseases, which have a mortality rate of 19.2% in a preterm infant and 2.1% in a full-term infant. Hence, universal screening for GBS colonization in pregnant women is conducted worldwide using the subculture procedure; however, infants born to GBS negative mothers sometimes contract GBS infections. Therefore, other laboratory techniques are required for detecting GBS more accurately. The proposed method "MALDI detection with analysis of peaks of TOF (MDAPT)" detects GBS directly from cultured broth with high sensitivity. Therefore, it can be an alternative method for GBS screening in pregnant women, thereby contributing to the prevention of severe GBS infectious diseases in neonates.
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Affiliation(s)
- Daiki Tanno
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Fukushima, Japan
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Kyoichi Saito
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kazutaka Ohashi
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Fukushima, Japan
| | - Masahiro Toyokawa
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Fukushima, Japan
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Yukio Yamadera
- Department of Clinical Laboratory, Fukushima Medical University Hospital, Fukushima, Japan
| | - Hiroki Shimura
- Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
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