An improved procedure based on fluorescence immunochromatography for rapid detection of group B streptococcus from enrichment cultures

Abstract

Background: Group B streptococcus (GBS) is a major cause of perinatal infectious morbidity and mortality. Although intrapartum antibiotic prophylaxis (IAP) administration for ≥ 4 h is effective in preventing neonatal early-onset GBS diseases, the conventional culture-based approach to identify GBS often takes 24–72 h. This study aimed to find a strategy to improve the efficacy of GBS screening. Methods: We developed a fluorescence immunochromatographic test (FICT) strip to detect GBS within 15 min. The detection limit, analytical sensitivity, cross-reactivity and performance of the strip were evaluated. The performance of the strip on vaginal-rectal swabs with or without enrichment culture was compared with real-time quantitative polymerase chain reaction (qPCR) and colloidal gold immunochromatography (GIC) assay with conventional enrichment culture method as the reference method. Results: The detection limit of the strip ranges from 104 CFU/mL to 106 CFU/mL. Additionally, the strip has detected all of the positives from 48 h enrichment cultures (175/175). and 30 GBS strains representing different serotypes at cell density of 106 CFU/mL yielded positive results. Cross-reactivity test indicated no false-positive results. The sensitivity on direct samples was 34.48%, while 4 h enrichment in LIM broth prior to FICT has greatly increased the sensitivity to 90.91% with the specificity being 95.35%. Conclusions: The improved procedure based on the FICT for GBS detection from short-term LIM broth cultures was expected to guide IAP administration in obstetrical emergencies.