Development and testing of two procedures for the quick detection of Streptococcus agalactiae in rectal-vaginal exudates
Keywords:
STREPTOCOCCUS AGALACTIAE, INFECTIOUS PREGNANCY COMPLICATIONSAbstract
Introduction: group B streptococcal infection (GBS) may seriously affect mother and fetuses during pregnancy, and the newborn after delivery. Today, diagnosis of colonization during pregnancy is done by means of microbiological methods of vaginal and rectal exudates.
Objective:to develop fast and low cost methods to detect the GBS specific group antigen in vaginal-rectal exudates.
Method: we used two EGB strains, one of the (IH23) autochthonous and the reference strain O90R, that only expresses the group specific polysaccharide. We prepared a polyclonal antiserum for each one of them which was used to conduct an immunochromatographic test and a latex agglutination test. We used bacterial culture, EGB purified polysaccharides and vagina,-rectal samples as control.
Results: detection limits obtained for the immunochromatographic test were 210 µg/ml and 50 µg/ml for purified polysaccharides and cell wall, respectively, there being no EGB antigens detected in the clinical samples analyzed. Latex detection limit was 65 µg/ml compared to purified polysaccharides of IH23 culture supernatant and 6,5 x 107 UFC/ml of IH23. Sensitivity and specificity for latex was 30% and 90% respectively.
Conclusions: the methods used failed to reach the detection limit required for its application in our clinical samples. This agrees with what is described in bibliography about quick tests based on antigen-antibody reactions and indicated the need to add previous extraction and concentration steps or to improve the quality of the immunologic reagents used.
References
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(23) Wever PC, Yzerman EP, Kuijper EJ, Speelman P, Dankert J. Rapid diagnosis of legionaries disease using an immunochromatographic assay for Legionella pneumophila serogroup 1 antigen in urine during an outbreak in the Netherlands. J Clin Microbiol 2000; 38(7): 2738-9.
(24) Curtis SN, Krause RM. Antigenic Relationships between groups B and G streptococci. J Exp Med 1964; 120: 629-37.
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(26) Wessels MR, Benedí WJ, Jennings HJ, Michon F, DiFabio JL, Kasper DL. Isolation and characterization of type IV group B Streptococcus capsular polysaccharide. Infect Immun 1989; 57(4): 1089-94.
(27) Horisberger M. Evaluation of colloidal gold as a cytochemical marker for transmission and scanning electron microscope. Biol Cell 1979; 36: 253-8.
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(29) Yancey MK, Armer T, Clark P, Duff P. Assessment of rapid identification tests for genital carriage of group B streptococci. Obstet Gynecol 1992; 80(6): 1038-47.
(30) Daniels J, Gray J, Pattison H, Roberts T, Edwards E, Milner P, et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess 2009; 13(42): 1-154.
(31) Helvetica Health Care. Bionexia Streptokokken B antigen. Disponible en:http://www.helveticahealthcare.com/BioNexia%20-%20brochures/Bionexia-flyer-StrepB%20-%20ENG-FR-GER.pdf. Consulta: 8 junio 2010.
(2) Edwards M. Group B Streptococcal Infections. In: Remington J, Klein J, Wilson Ch, Baker C, eds. Infectious diseases of the fetus and newborn infant. 6th ed. Philadelphia: Elsevier, Saunders, 2006: 404-64.
(3) Centers for Disease Control and Prevention. Group B Streptococcal Prevention. Atlanta: CDC, 2006.
(4) Verani JR, McGee L, Schrag SJ; Division of Bacterial Diseases, National Centerfor Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59(RR-10): 1-36.
(5) Jaime WE, Edwards RK, Duff P. Vaginal-perianal compared with vaginal-rectal cultures for identification of group B streptococci. Obstet Gynecol 2004; 104(5 Pt 1): 1058-61.
(6) Jauréguy F, Carton M, Teboul J, Butel MJ, Panel P, Ghnassia JC, et al. Risk factors and screening strategy for group B streptococcal colonization in pregnant women: results of a prospective study. J Gynecol Obstet Biol Reprod (Paris) 2003; 32(2): 132-8.
(7) Stoll BJ, Schuchat A. Maternal carriage of group B streptococci in developing countries. Pediatr Infect Dis J 1998; 17(6): 499-503.
(8) Orrett F. Colonization of Group B Streptococci in pregnancy and outcome of infected neonates in Trinidad. Pediatr Int 2003; 45(3): 319-23.
(9) de Lourdes Collado M, Kretschmer RR, Becker I, Guzmán A, Gallardo L, Lepe CM. Colonization of Mexican pregnant women with group B Streptococcus (Letter). J Infect Dis 1981; 143(1): 134.
(10) Barillaro S, Monzo C, Negrin G, Brazeiro D. Prevalencia del estreptococo beta agalactiae en la población de embarazadas que consultan en la D.N.S.FF.AA. Salud Militar 2003; 25(1). Disponible en: http://www.dnsffaa.gub.uy/revista/vol25/P48a57V25.htm. Consulta: 7 junio 2010.
(11) Rivas C, Tallac I, Etchenique A. Colonización vaginorrectal por Streptococcus del grupo B en mujeres embarazadas, entre las 35 a 37 semanas de gestación. Rev Méd Urug 2006; 22(3): 191-6.
(12) Bello Pedrosa O, Perotti Pais E. Enfermedad invasiva por estreptococo del grupo B. Arch Pediatr Urug 2004; 75(2): 150-4
(13) Laufer J, Scasso S, Sosa C, Rodríguez-Cuns G, Alonso J, Pons J. Group B streptococcus colonization among pregnant women in Uruguay. Int J Gynaecol Obstet 2009; 104(3): 242-3.
(14) Ministerio de Salud Pública. Dirección General de la Salud. Programa Nacional Prioritario de Salud de la Mujer y Género. Guías en salud sexual y reproductiva: normas de atención a la mujer embarazada. Disponible en: http://www.msp.gub.uy/uc_1667_1.html. Consulta: 7 junio 2010.
(15) Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC. MWWR Recomm Rep 2002; 51(RR-11): 1-22.
(16) Smaill F. Intrapartum antibiotics for group B streptococcal colonisation. Cochrane Database Syst Rev 2000; (2): CD000115.
(17) Money DM, Dobson S; Canadian Paediatric Society. Infectious Diseases Commitee. The prevention of early-onset neonatal group B streptococcal disease. J Obstet Gynaecol Can 2004; 26(9): 826-32.
(18) Amstey MS, Gibbs RS. Is penicillin G a better choice than ampicillin for prophylaxis of neonatal group B streptococcal infections? Obstet Gynecol 1994; 84(6): 1058-9.
(19) Royal College of Obstetricians and Gynaecologists. Group B Streptococcal Disease, Early Onset (Green-top 36): prevention of early onset neonatal group B streptococcal disease. London: RCOG, 2003.
(20) Picard F, Bergeron M. Laboratory detection of group B Streptococcus for prevention of perinatal disease. Eur J Clin Microbiol Infect Dis 2004; 23(9): 665-71.
(21) Edwards RK, Novak-Weekley SM, Koty PP, Davis T, Leeds LJ, Jordan JA. Rapid group B streptococci screening using a real-time polymerase chain reaction assay. Obstet Gynecol 2008; 111(6): 1335-41.
(22) Hujakka H, Koistinen V, Eerikäinen P, Kuronen I, Mojonen I, Parviainen M, et al. New immunochromatographic rapid test for diagnosis of acute Puumala Virus Infection. J Clin Microbiol 2001; 39(6): 2146-50.
(23) Wever PC, Yzerman EP, Kuijper EJ, Speelman P, Dankert J. Rapid diagnosis of legionaries disease using an immunochromatographic assay for Legionella pneumophila serogroup 1 antigen in urine during an outbreak in the Netherlands. J Clin Microbiol 2000; 38(7): 2738-9.
(24) Curtis SN, Krause RM. Antigenic Relationships between groups B and G streptococci. J Exp Med 1964; 120: 629-37.
(25) Baker CJ, Kasper DL, Davis CE. Immunochemical characterization of the nativetype III polysaccharide of group B streptococcus. J Exp Med 1976; 143(2): 258-70.
(26) Wessels MR, Benedí WJ, Jennings HJ, Michon F, DiFabio JL, Kasper DL. Isolation and characterization of type IV group B Streptococcus capsular polysaccharide. Infect Immun 1989; 57(4): 1089-94.
(27) Horisberger M. Evaluation of colloidal gold as a cytochemical marker for transmission and scanning electron microscope. Biol Cell 1979; 36: 253-8.
(28) Hermanson GT. Bioconjugate Techniques. San Diego, California: Academic Press, 1996: 593-604.
(29) Yancey MK, Armer T, Clark P, Duff P. Assessment of rapid identification tests for genital carriage of group B streptococci. Obstet Gynecol 1992; 80(6): 1038-47.
(30) Daniels J, Gray J, Pattison H, Roberts T, Edwards E, Milner P, et al. Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess 2009; 13(42): 1-154.
(31) Helvetica Health Care. Bionexia Streptokokken B antigen. Disponible en:http://www.helveticahealthcare.com/BioNexia%20-%20brochures/Bionexia-flyer-StrepB%20-%20ENG-FR-GER.pdf. Consulta: 8 junio 2010.
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2011-06-30
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Iglesias T, Cáceres S, Rey G, Rimsky G, Varela G, Mota MI, et al. Development and testing of two procedures for the quick detection of Streptococcus agalactiae in rectal-vaginal exudates. Rev. Méd. Urug. [Internet]. 2011 Jun. 30 [cited 2024 Nov. 24];27(2):73-81. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/392
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