caa a22 4500 606156240 CHVBK 20210128100607.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10096-015-2496-5 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2496-5 Real-time polymerase chain reaction and culture in the diagnosis of invasive group B streptococcal disease in infants: a retrospective study [Elektronische Daten] [M. Meehan, M. Cafferkey, S. Corcoran, A. Foran, N. Hapnes, D. LeBlanc, C. McGuinness, U. Nusgen, N. O'Sullivan, R. Cunney, R. Drew] Group B streptococcus (GBS) is a leading cause of invasive disease in infants. Accurate and rapid diagnosis is crucial to reduce morbidity and mortality. Real-time polymerase chain reaction (PCR) targeting the dltR gene was utilised for the direct detection of GBS DNA in blood and cerebrospinal fluid (CSF) from infants at an Irish maternity hospital. A retrospective review of laboratory and patient records during the period 2011-2013 was performed in order to evaluate PCR and culture for the diagnosis of invasive GBS disease. A total of 3570 blood and 189 CSF samples from 3510 infants had corresponding culture and PCR results. Culture and PCR exhibited concordance in 3526 GBS-negative samples and 13 (25%) GBS-positive samples (n = 53). Six (11%) and 34 (64%) GBS-positive samples were positive only in culture or PCR, respectively. Culture and PCR identified more GBS-positive infants (n = 47) than PCR (n = 43) or culture (n = 16) alone. Using culture as the reference standard, the sensitivity, specificity, and positive and negative predictive values for PCR on blood samples were 71.4%, 99.2%, 25% and 99.9%, and for CSF samples, they were 60%, 97.8%, 42.9% and 98.9%, respectively. The sensitivity and positive predictive values were improved (blood: 84.6% and 55%; CSF: 77.8% and 100%, respectively) when maternal risk factors and other laboratory test results were considered. The findings in this study recommend the use of direct GBS real-time PCR for the diagnosis of GBS infection in infants with a clinical suspicion of invasive disease and as a complement to culture, but should be interpreted in the light of other laboratory and clinical findings. Springer-Verlag Berlin Heidelberg, 2015 Meehan M. Epidemiology and Molecular Biology Unit, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut Cafferkey M. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut Corcoran S. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut Foran A. Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut Hapnes N. Rotunda Hospital, Dublin, Ireland aut LeBlanc D. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut McGuinness C. Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut Nusgen U. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut O'Sullivan N. Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut Cunney R. Epidemiology and Molecular Biology Unit, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut Drew R. Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/12(2015-12-01), 2413-2420 0934-9723 34:12<2413 2015 34 10096 https://doi.org/10.1007/s10096-015-2496-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2496-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Meehan M. Epidemiology and Molecular Biology Unit, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut NATIONALLICENCE 700 1- Cafferkey M. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut NATIONALLICENCE 700 1- Corcoran S. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut NATIONALLICENCE 700 1- Foran A. Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut NATIONALLICENCE 700 1- Hapnes N. Rotunda Hospital, Dublin, Ireland aut NATIONALLICENCE 700 1- LeBlanc D. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut NATIONALLICENCE 700 1- McGuinness C. Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut NATIONALLICENCE 700 1- Nusgen U. Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland aut NATIONALLICENCE 700 1- O'Sullivan N. Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut NATIONALLICENCE 700 1- Cunney R. Epidemiology and Molecular Biology Unit, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut NATIONALLICENCE 700 1- Drew R. Irish Meningococcal and Meningitis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Dublin, Ireland aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/12(2015-12-01), 2413-2420 0934-9723 34:12<2413 2015 34 10096