Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device
IntroductionUniversal screening for the detection of group B streptococcus (GBS) colonization in pregnant women was recently introduced in Slovenia. The aim of our study was to determine whether self-collection of rectovaginal swabs is a valid alternative to collection by healthcare workers (HCWs).M...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2025.1541319/full |
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| author | Iva Kukovica Neža Omahen Nika Klobučar Martina Bučar Anita Franko Rutar Tina Perme Tina Perme Miha Lučovnik Miha Lučovnik Samo Jeverica Samo Jeverica |
| author_facet | Iva Kukovica Neža Omahen Nika Klobučar Martina Bučar Anita Franko Rutar Tina Perme Tina Perme Miha Lučovnik Miha Lučovnik Samo Jeverica Samo Jeverica |
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| description | IntroductionUniversal screening for the detection of group B streptococcus (GBS) colonization in pregnant women was recently introduced in Slovenia. The aim of our study was to determine whether self-collection of rectovaginal swabs is a valid alternative to collection by healthcare workers (HCWs).MethodsA prospective, multicenter study was conducted between June and November 2023. A total of 227 pregnant women (aged 20 to 44 years) from the University Medical Center Ljubljana (n = 136), the Novo mesto Community Health Center (n = 48) and the Trebnje Community Health Center (n = 43) were included. Two swabs were taken: swab A by the HCWs using standard semi-solid Amies transport medium (Meus; current standard) and swab B by the pregnant woman following visual instructions using a commercial LIM Broth (Copan). Swabs were inoculated onto ChromID Strepto B (STRB) agars directly and after overnight enrichment in LIM broth. The NeuMoDx GBS assay was performed from the enrichment broth. A self-assessment questionnaire was completed after sampling. Performance characteristics were calculated and compared between different diagnostics test algorithms using McNemar’s test for paired samples.ResultsOverall, GBS was detected in 18% (95% CI 13–23%; n = 40) of swabs A and 19% (95% CI 14–25%; n = 43) of swabs B. PCR was superior in both groups. In the group of swabs collected by HCWs, 4 (40 vs. 36; 11.1% difference; p = 0.046) and 3 (40 vs. 37; 8.1% difference; p = 0.083) additional positives were detected with PCR compared to direct and enrichment culture, respectively; in the group of self-collected swabs, 4 (43 vs. 39; 10.3% difference; p = 0.046) and 6 (43 vs. 36; 16.2% difference; p = 0.014) additional positives were detected with PCR compared to direct and enrichment culture, respectively. Self-collection showed a trend towards a higher diagnostic yield. PCR after enrichment from self-collected samples was found to be the most sensitive method overall. 58.5% (n = 124/212; 95% CI 52–65%) of women would prefer the swabs taken by HCWs.DiscussionSelf-collection of rectovaginal swabs during pregnancy is a good alternative to HCW-collected swabs. PCR from enrichment broth was better for the detection of GBS compared to enrichment culture. Majority of women preferred swabs taken by HCWs. |
| format | Article |
| id | doaj-art-d4fb416c0b0d484d89c5afb0da32b58e |
| institution | Kabale University |
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| publishDate | 2025-02-01 |
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| spelling | doaj-art-d4fb416c0b0d484d89c5afb0da32b58e2025-02-05T07:32:22ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-02-011610.3389/fmicb.2025.15413191541319Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment deviceIva Kukovica0Neža Omahen1Nika Klobučar2Martina Bučar3Anita Franko Rutar4Tina Perme5Tina Perme6Miha Lučovnik7Miha Lučovnik8Samo Jeverica9Samo Jeverica10Department of Perinatology, University Medical Centre Ljubljana, Ljubljana, SloveniaNational Laboratory of Health, Environment and Food, Maribor, SloveniaNational Laboratory of Health, Environment and Food, Maribor, SloveniaCommunity Health Center Novo mesto, Novo mesto, SloveniaCommunity Health Center Trebnje, Trebnje, SloveniaDepartment of Perinatology, University Medical Centre Ljubljana, Ljubljana, SloveniaMedical Faculty, University of Ljubljana, Ljubljana, SloveniaDepartment of Perinatology, University Medical Centre Ljubljana, Ljubljana, SloveniaMedical Faculty, University of Ljubljana, Ljubljana, SloveniaNational Laboratory of Health, Environment and Food, Maribor, SloveniaIzola General Hospital, Izola, SloveniaIntroductionUniversal screening for the detection of group B streptococcus (GBS) colonization in pregnant women was recently introduced in Slovenia. The aim of our study was to determine whether self-collection of rectovaginal swabs is a valid alternative to collection by healthcare workers (HCWs).MethodsA prospective, multicenter study was conducted between June and November 2023. A total of 227 pregnant women (aged 20 to 44 years) from the University Medical Center Ljubljana (n = 136), the Novo mesto Community Health Center (n = 48) and the Trebnje Community Health Center (n = 43) were included. Two swabs were taken: swab A by the HCWs using standard semi-solid Amies transport medium (Meus; current standard) and swab B by the pregnant woman following visual instructions using a commercial LIM Broth (Copan). Swabs were inoculated onto ChromID Strepto B (STRB) agars directly and after overnight enrichment in LIM broth. The NeuMoDx GBS assay was performed from the enrichment broth. A self-assessment questionnaire was completed after sampling. Performance characteristics were calculated and compared between different diagnostics test algorithms using McNemar’s test for paired samples.ResultsOverall, GBS was detected in 18% (95% CI 13–23%; n = 40) of swabs A and 19% (95% CI 14–25%; n = 43) of swabs B. PCR was superior in both groups. In the group of swabs collected by HCWs, 4 (40 vs. 36; 11.1% difference; p = 0.046) and 3 (40 vs. 37; 8.1% difference; p = 0.083) additional positives were detected with PCR compared to direct and enrichment culture, respectively; in the group of self-collected swabs, 4 (43 vs. 39; 10.3% difference; p = 0.046) and 6 (43 vs. 36; 16.2% difference; p = 0.014) additional positives were detected with PCR compared to direct and enrichment culture, respectively. Self-collection showed a trend towards a higher diagnostic yield. PCR after enrichment from self-collected samples was found to be the most sensitive method overall. 58.5% (n = 124/212; 95% CI 52–65%) of women would prefer the swabs taken by HCWs.DiscussionSelf-collection of rectovaginal swabs during pregnancy is a good alternative to HCW-collected swabs. PCR from enrichment broth was better for the detection of GBS compared to enrichment culture. Majority of women preferred swabs taken by HCWs.https://www.frontiersin.org/articles/10.3389/fmicb.2025.1541319/fullgroup B streptococcusself-collectionenrichment culturePCRchromogenic agarscreening |
| spellingShingle | Iva Kukovica Neža Omahen Nika Klobučar Martina Bučar Anita Franko Rutar Tina Perme Tina Perme Miha Lučovnik Miha Lučovnik Samo Jeverica Samo Jeverica Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device Frontiers in Microbiology group B streptococcus self-collection enrichment culture PCR chromogenic agar screening |
| title | Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device |
| title_full | Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device |
| title_fullStr | Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device |
| title_full_unstemmed | Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device |
| title_short | Comparison of self-collected and healthcare worker-collected rectovaginal swabs for group B streptococcus detection in pregnancy using PCR with a commercial collection-enrichment device |
| title_sort | comparison of self collected and healthcare worker collected rectovaginal swabs for group b streptococcus detection in pregnancy using pcr with a commercial collection enrichment device |
| topic | group B streptococcus self-collection enrichment culture PCR chromogenic agar screening |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2025.1541319/full |
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