Ann Clin Microbiol.  2017 Jun;20(2):42-51. 10.5145/ACM.2017.20.2.42.

Diagnostic Accuracy and Detection Rate of Real-Time PCR for Detection of Group B Streptococcal Colonization in Pregnant Women: Systemic Review of Literature and Meta-Analysis

• Park SY
• Kim SY
• Choi WJ
• Kim SH
• Hong SG

• KMID: 2383230
• DOI: http://doi.org/10.5145/ACM.2017.20.2.42

Abstract

BACKGROUND
Group B streptococcus (Streptococcus agalactiae, GBS) was reported as a major cause of neonatal infection and death. To prevent vertical transmission, CDC recommended that all women in week 35-37 of pregnancy should receive the GBS colonization test. We conducted a systematic review and meta-analysis to evaluate diagnostic accuracy and detection rate of real-time PCR for GBS in pregnant women.
METHODS
The literature review for GBS using real-time PCR was done including KoreaMed, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library on November 3, 2015. 443 articles were collected. Two authors select articles and evaluated the quality of studies using Scottish Intercollegiate Guidelines Network tool independently.
RESULTS
Diagnostic accuracy of the real-time PCR was assessed by meta-analysis through 34 articles (13,516 for real-time PCR, 1,815 for culture and other comparison test). The GBS colonization was assessed through 34 articles, which reported varying values of 2.0-69.2% using real-time PCR. The real-time PCR for GBS was shown to have overall sensitivity of 0.93 (95% CI 0.92-0.94, I2=86.3%), overall specificity of 0.96 (95% CI 0.96-0.96, I2=90.2%), SROC AUC of 0.99.
CONCLUSION
Real-time PCR is an effective test for detecting GBS colonization in pregnant women, resulted in preventing the infection in a new born baby.

Keyword

Group B streptococcus; Pregnant women; Real-time polymerase chain reaction; Streptococcus agalactiae

MeSH Terms

Area Under Curve
Centers for Disease Control and Prevention (U.S.)
Colon*
Female
Humans
Pregnancy
Pregnant Women*
Real-Time Polymerase Chain Reaction*
Sensitivity and Specificity
Streptococcus
Streptococcus agalactiae

Figure

• 

  Fig. 1 Literature search flow diagram.

• 

  Fig. 2 Forest plot of real-time PCR for GBS detection (Evidence level of articles: 2++). Pooled sensitivity (A), pooled specificity (B) and summary receiver operating characteristic area under the curve (C). Abbreviations: CI, confidence interval; Q*, heterogeneity statistic; SE, standard error; SROC AUC, summary receiver operating characteristic area under the curve.

• 

  Fig. 3 Forest plot of real-time PCR for GBS detection (Evidence level of articles: 2+). Pooled sensitivity (A), pooled specificity (B) and summary receiver operating characteristic area under the curve (C). Abbreviations: CI, confidence interval; Q*, heterogeneity statistic; SE, standard error; SROC AUC, summary receiver operating characteristic area under the curve.

• 

  Fig. 4 Forest plot of comparator/reference test for GBS detection. Abbreviations: CI, confidence interval; FN, false negative; FP, false positive; LAMP, loop-mediated isodermal DNA amplification; OIA, optical immunoassay; PCR, polymerase chain reaction; TN, true negative; TP, true positive.

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