Exploring the Feasibility of Intrapartum GBS Collection to Identify Residual GBS in a Pilot Study of an Antenatal Probiotic Intervention

Emily Malloy, L. Hanson, L. Vandevusse, Karen Robinson, Maharaj Singh, Marie Forgie
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Abstract

(1) Background: We aimed to explore the feasibility of collecting intrapartum maternal Group B Streptococcus (GBS) colonization and immediate post-birth neonatal GBS colonization cultures for use in a larger trial and to identify cases of residual GBS, which were hypothesized to be less common in the probiotics group. (2) Methods: This sub-study added additional outcome measures to the parent study to identify intrapartum and neonatal colonization and compare between probiotic and placebo groups and to identify cases of residual GBS. Intrapartum maternal vaginal and rectal GBS cultures were collected at the time of admission to a hospital for labor and to give birth. Neonatal oral and nasopharynx GBS cultures were collected within 1–2 h of giving birth. (3) Results: Thirty intrapartum samples were collected; twenty-eight had complete data. The antepartum GBS results significantly predicted the intrapartum results (p = 0.005), with 86.7% of cultures remaining the same at both time points. There were four cases where the intrapartum GBS results were different to the 36-week antepartum cultures results. A case of residual GBS was identified in one probiotic group participant. None of the neonatal swabs were positive for GBS. No cases of EOGBSD occurred in infants born to the study participants. (4) Conclusions: Although the 36–37 week GBS results significantly predicted the intrapartum results, the utility for a larger research trial on probiotics to reduce antenatal GBS is unclear. Intrapartum GBS swab collection was feasible in a busy nurse, midwife, and physician practice. GBS was not recovered from neonatal oral and nasopharyngeal swabs. The pathways of neonatal GBS colonization require further study.
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在产前益生菌干预的试点研究中,探索产时收集GBS以识别残留GBS的可行性
(1)背景:我们的目的是探索收集产妇产时B族链球菌(GBS)定植和出生后新生儿GBS定植培养的可行性,以用于更大规模的试验,并确定残留的GBS病例,这在益生菌组中被假设不太常见。(2)方法:本亚研究在母体研究的基础上增加了额外的结局指标,以确定产时和新生儿定植,比较益生菌组和安慰剂组之间的差异,并确定残留的GBS病例。在分娩和分娩入院时收集产妇阴道和直肠GBS培养。在分娩后1-2小时内收集新生儿口腔和鼻咽GBS培养物。(3)结果:采集产时标本30份;28人有完整的数据。产前GBS结果显著预测产时结果(p = 0.005), 86.7%的培养物在两个时间点保持相同。有4例产时GBS结果与产前36周培养结果不同。在一名益生菌组参与者中发现了残留的GBS病例。所有新生儿拭子均未检测出GBS阳性。研究参与者所生的婴儿中没有出现EOGBSD病例。(4)结论:虽然36-37周的GBS结果可以显著预测产时结果,但益生菌减少产前GBS的大规模研究试验的效用尚不清楚。在繁忙的护士、助产士和医生的实践中,产时收集GBS拭子是可行的。新生儿口腔和鼻咽拭子未恢复GBS。新生儿GBS定植途径有待进一步研究。
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