Evaluation of suprapubic bladder aspiration for detection of group B streptococcal antigen by latex agglutination in neonatal urine

April L. Palmer, N. Kristine Leos, Mary Hall, Gregory L. Jackson, Pablo J. Sánchez

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Our objective was to determine whether urine collection by suprapubic bladder aspiration (SBA) improves the specificity of the group B streptococcal (GBS) latex agglutination (LA) test by avoiding contamination of urine with GBS from perineal and rectal colonization that can result in a positive LA test in an uninfected infant when the urine is collected by bag. Part 1 consists of a retrospective review of the medical records of 113 infants who had urine collected by SBA for GBS LA testing as part of evaluation for possible sepsis. The sensitivity and specificity of the urine LA test was assessed by comparing it with blood culture results. In part 2, a prospective analysis was performed of 19 newborns who had rectal and vaginal/penile cultures as well as urine by SBA and bag for GBS cultures and LA. Results of LA testing on urine collected by both of these methods were compared with results of urine, perineal, and rectal cultures. In the retrospective review of GBS LA testing performed on 113 consecutive urine specimens collected by SBA from neonates being evaluated for suspected sepsis, the sensitivity and specificity were 67% and 89%, respectively, when compared with blood culture results. Twelve infants who had a positive LA test result but a sterile blood culture (BC-, LA+) were compared with 95 infants with both blood cultures and urine LA tests negative for GBS (BC-, LA-). BC-, LA+ infants were more likely than those with BC-, LA- to have an immature to total neutrophil (I/T) ratio ≥0.16 at 12 and 24 hours (p=0.04 and 0.02, respectively). In the prospective study, we found that a positive GBS LA test can be due to perineal contamination and possibly to gastrointestinal absorption of GBS antigen. No false positive LA test results occurred on urine obtained by SBA; however, use of this method failed to detect the one infant with GBS bacteremia. Because of suboptimal sensitivity and specificity, use of the GBS LA test on urine obtained either by SBA or bag cannot be recommended for diagnosis of early onset GBS disease.

Original languageEnglish (US)
Pages (from-to)235-XIII
JournalAmerican Journal of Perinatology
Volume13
Issue number4
StatePublished - May 1996

Fingerprint

Agglutination
Latex
Latex Fixation Tests
Urinary Bladder
Urine
Antigens
Sensitivity and Specificity
Sepsis
Newborn Infant
Urine Specimen Collection
Bacteremia
Medical Records
Neutrophils
Prospective Studies

Keywords

  • Latex agglutination test
  • Streptococcus group B

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Evaluation of suprapubic bladder aspiration for detection of group B streptococcal antigen by latex agglutination in neonatal urine. / Palmer, April L.; Leos, N. Kristine; Hall, Mary; Jackson, Gregory L.; Sánchez, Pablo J.

In: American Journal of Perinatology, Vol. 13, No. 4, 05.1996, p. 235-XIII.

Research output: Contribution to journalArticle

Palmer, April L. ; Leos, N. Kristine ; Hall, Mary ; Jackson, Gregory L. ; Sánchez, Pablo J. / Evaluation of suprapubic bladder aspiration for detection of group B streptococcal antigen by latex agglutination in neonatal urine. In: American Journal of Perinatology. 1996 ; Vol. 13, No. 4. pp. 235-XIII.
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