title: The effect of a chlorhexidine-based surgical lubricant during pelvic examination on the detection of group B Streptococcus.
abstract: OBJECTIVE
  The objective of the study was to estimate whether surgical lubricant used during pelvic examination alters the detection of group B Streptococcus (GBS).
  
  
  METHODS
  We conducted a prospective cohort study of patients undergoing GBS screening at the prenatal clinics of a New York City public hospital. Two specimens were collected from each patient, before and after a pelvic examination with Surgilube (Fougera and Co, Melville, NY), a bacteriostatic surgical lubricant. Test performance indices using GBS status pre-pelvic examination as the reference were calculated.
  
  
  RESULTS
  Over 10 months, 168 patients were enrolled in the study. Twenty of 168 patients (11.9%; 95% confidence interval, 7.4-17.8%) tested GBS positive before the pelvic examination. Of the initial 20 GBS-positive patients, 10 tested GBS positive after the pelvic examination with surgical lubricant. The sensitivity of detecting GBS after the examination with surgical lubricant was 50%.
  
  
  CONCLUSIONS
  Because pelvic examination with surgical lubricant may decrease the detection of GBS, obstetric practitioners should collect GBS screening cultures before the use of surgical lubricant.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Ora I
authors.initials: OI
authors.lastname: Schwope
authors.forename: Katherine T
authors.initials: KT
authors.lastname: Chen
authors.forename: Isha
authors.initials: I
authors.lastname: Mehta
authors.forename: Margaret
authors.initials: M
authors.lastname: Re
authors.forename: Larry
authors.initials: L
authors.lastname: Rand
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000032:analysis*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000032:analysis; D005260:Female; D006801:Humans; D054327:Lubricants / Q000008:administration & dosage / Q000737:chemistry*; D010808:Physical Examination; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D014621:Vagina / Q000382:microbiology*
chemical_list: D000891:Anti-Infective Agents, Local; D054327:Lubricants; C010882:chlorhexidine gluconate; D002710:Chlorhexidine