title: Group B streptococcal PCR testing in comparison to culture for diagnosis of late onset bacteraemia and meningitis in infants aged 7-90 days: a multi-centre diagnostic accuracy study.
abstract: The aim of this study was to compare an in-house real-time PCR assay, with bacterial culture as the reference, for the diagnosis of late onset group B Streptococcal (GBS) disease. This was a retrospective review. All children aged 7-90 days presenting to four paediatric centres that had a blood or CSF sample tested by GBS PCR were included. Of 7,686 blood and 2,495 cerebrospinal fluid (CSF) samples from patients of all ages received for PCR testing, 893 and 859 samples were eligible for the study, respectively. When compared to culture, the sensitivity of blood PCR was 65% (13/20) in comparison to the CSF PCR test which was 100% (5/5). Ten of 23 PCR-positive blood samples and 17 of 22 PCR-positive CSF samples were culture negative. The median threshold Ct values for culture-positive/PCR-positive CSF samples was lower than that of culture-negative/PCR-positive CSF samples (p = 0.08). Clinical details of 17 available cases that were culture negative/PCR positive were reviewed; seven were deemed to be definite cases, eight were probable and two were possible. The results showed that detection of GBS by PCR is useful for CSF samples from infants aged 7-90 days with suspected meningitis; however, analysis of blood samples by PCR is of limited value as a routine screening test for late onset GBS sepsis and should not replace bacterial culture.
authors.affiliation: Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland.
authors.forename: S M
authors.initials: SM
authors.lastname: Morrissey
authors.affiliation: Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Nielsen
authors.affiliation: Department of Microbiology, University Hospital Waterford, Co. Waterford, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Ryan
authors.affiliation: Departments of Microbiology and Paediatric Infectious Diseases, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.
authors.forename: H
authors.initials: H
authors.lastname: Al Dhanhani
authors.affiliation: Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Meehan
authors.affiliation: Department of Microbiology, Our Lady's Hospital, Co. Louth, Drogheda, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: McDermott
authors.affiliation: Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: O'Sullivan
authors.affiliation: Department of Microbiology, University Hospital Waterford, Co. Waterford, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Doyle
authors.affiliation: Departments of Microbiology and Paediatric Infectious Diseases, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Gavin
authors.affiliation: Departments of Microbiology and Paediatric Infectious Diseases, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: O'Sullivan
authors.affiliation: Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Cunney
authors.affiliation: Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Dublin 1, Ireland. rdrew@rotunda.ie.|Department of Microbiology, Rotunda Hospital, Dublin 1, Ireland. rdrew@rotunda.ie.|Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin 2, Ireland. rdrew@rotunda.ie.|Rotunda Hospital, Parnell Square, Dublin 1, Ireland. rdrew@rotunda.ie.
authors.forename: R J
authors.initials: RJ
authors.lastname: Drew
mesh_terms: D016470:Bacteremia / Q000175:diagnosis*; D001431:Bacteriological Techniques / Q000379:methods*; D001769:Blood / Q000382:microbiology; D002555:Cerebrospinal Fluid / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000067562:Late Onset Disorders / Q000175:diagnosis*; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*