Abstract
Group B Streptococcus (GBS) is associated with invasive infections in newborns. The obstetric field requires a rapid method for obtaining GBS screening results. Our objective was to determine whether a sensitive real-time PCR assay demonstrates acceptable diagnostic performance. This study involved 301 pregnant women. Vaginal and rectal swabs were collected between 35 and 37 weeks of gestation. We report the diagnostic performance of the sensitive real-time PCR assay compared to composite reference method, along with 95% confidence intervals (CI). Positive results were detected in 35 cases (11.6%), 27 cases (8.9%), and 21 cases (6.9%), using real-time PCR, real-time PCR after enrichment, and microbial culture methods, respectively. Microbial culture and sequencing were applied as composite reference method, the sensitivity of real-time PCR was 96.15%, specificity was 96.36%, and diagnostic accuracy was 96.34%. Compared with the composite reference method, the sensitivity and specificity of the real-time PCR detection method after enrichment was 96.15% and 99.27%, with a diagnostic accuracy of 99.0%. Microbial culture demonstrated a sensitivity of 80.77%, specificity of 100%, and diagnostic accuracy of 98.33%. This study demonstrates that the sensitive real-time PCR assay represents an acceptable rapid GBS screening method, offering clinicians a new option for early screening.
Data availability
The data supporting the reported results are available on request from the corresponding author.
References
Goodman, J. R. et al. Longitudinal Study of Group B Streptococcus Carriage in Pregnancy. Infect. Obstet. Gynecol. 5 (3), 237–243. https://doi.org/10.1155/S1064744997000409 (1997).
Prevention of Group B Streptococcal Early-Onset Disease in Newborns. ACOG Committee Opinion, Number 797. Obstet. Gynecol. 135 (2), e51–e72. https://doi.org/10.1097/aog.0000000000003668 (2020).
Wu, M. et al. Development of risk prediction nomogram for neonatal sepsis in Group B Streptococcus-colonized mothers: a retrospective study. Sci. Rep. 14 (1), 5629. https://doi.org/10.1038/s41598-024-55783-2 (2024).
Chaguza, C. et al. Population genomics of Group B Streptococcus reveals the genetics of neonatal disease onset and meningeal invasion. Nat. Commun. 13 (1), 4215. https://doi.org/10.1038/s41467-022-31858-4 (2022).
Huang, J., Lin, X. Z., Zhu, Y. & Chen, C. Epidemiology of group B streptococcal infection in pregnant women and diseased infants in mainland China. Pediatr. Neonatol. 60 (5), 487–495. https://doi.org/10.1016/j.pedneo.2019.07.001 (2019).
Prevention of Perinatal Group B Streptococcal Disease Revised Guidelines from CDC. Morb Mortal Wkly Rep Recomm Rep. 2010;59(RR-10):1–36. (2010).
Puopolo, K. M., Madoff, L. C. & Eichenwald, E. C. Early-Onset Group B Streptococcal Disease in the Era of Maternal Screening. Pediatrics 115 (5), 1240–1246. https://doi.org/10.1542/peds.2004-2275 (2005).
Han, M. Y. et al. Evaluation of Xpert GBS assay and Xpert GBS LB assay for detection of Streptococcus agalactiae. Ann. Clin. Microbiol. Antimicrob. 20 (1), 62. https://doi.org/10.1186/s12941-021-00461-8 (2021).
Shin, J. H. & Pride, D. T. Comparison of Three Nucleic Acid Amplification Tests and Culture for Detection of Group B Streptococcus from Enrichment Broth. Richter SS, ed. J Clin Microbiol. ;57(6):e01958-18. (2019). https://doi.org/10.1128/JCM.01958-18
Peris, M. P. et al. Retrospective Study for the Clinical Evaluation of a Real-Time PCR Assay with Lyophilized and Ready-to-Use Reagents for Streptococcus agalactiae Detection in Prenatal Screening Specimens. Diagnostics 12 (9), 2189. https://doi.org/10.3390/diagnostics12092189 (2022).
Peng, J. et al. Accuracy of real-time polymerase chain reaction test for Group B Streptococcus detection in pregnant women: A systematic review and meta-analysis. Eur. J. Obstet. Gynecol. Reprod. Biol. 304, 141–151. https://doi.org/10.1016/j.ejogrb.2024.11.035 (2025).
Silbert, S., Rocchetti, T. T., Gostnell, A., Kubasek, C. & Widen, R. Detection of Group B Streptococcus Directly from Collected ESwab Samples by Use of the BD Max GBS Assay. McAdam AJ, ed. J. Clin. Microbiol. 54 (6), 1660–1663. https://doi.org/10.1128/JCM.00445-16 (2016).
Sung, J. H. et al. Diagnostic Accuracy of Loop-Mediated Isothermal Amplification Assay for Group B Streptococcus Detection in Recto-Vaginal Swab: Comparison with Polymerase Chain Reaction Test and Conventional Culture. Diagnostics 12 (7), 1569. https://doi.org/10.3390/diagnostics12071569 (2022).
Koliwer-Brandl, H. et al. Evaluation of two rapid commercial assays for detection of Streptococcus agalactiae from vaginal samples. Acta Obstet. Gynecol. Scand. 102 (4), 450–456. https://doi.org/10.1111/aogs.14519 (2023).
Di Renzo GC, Melin P, Berardi A, et al. Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference. J. Matern Fetal Neonatal Med. 28 (7), 766–782. https://doi.org/10.3109/14767058.2014.934804 (2015).
Nadeau, H. C. G. et al. Vaginal-perianal or vaginal-perineal compared with vaginal-rectal culture-based screening for Group B Streptococci (GBS) colonization during the third trimester of pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 22 (1), 204. https://doi.org/10.1186/s12884-022-04546-w (2022).
Di Renzo, G. C. et al. Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference. J Matern Fetal Neonatal Med. ;28(7):766–782. (2015). https://doi.org/10.3109/14767058.2014.934804
Schwartz, J., Robinson-Dunn, B., Makin, J. & Boyanton, B. L. Evaluation of the BD MAX GBS assay to detect Streptococcus group B in LIM broth–enriched antepartum vaginal–rectal specimens. Diagn. Microbiol. Infect. Dis. 73 (1), 97–98. https://doi.org/10.1016/j.diagmicrobio.2012.01.016 (2012).
Couturier, B. A., Weight, T., Elmer, H. & Schlaberg, R. Antepartum Screening for Group B Streptococcus by Three FDA-Cleared Molecular Tests and Effect of Shortened Enrichment Culture on Molecular Detection Rates. Carroll KC, ed. J Clin Microbiol. ;52(9):3429–3432. (2014). https://doi.org/10.1128/JCM.01081-14
Miller, S. A., Deak, E. & Humphries, R. Comparison of the AmpliVue, BD Max System, and illumi gene Molecular Assays for Detection of Group B Streptococcus in Antenatal Screening Specimens. Richter SS, ed. J Clin Microbiol. ;53(6):1938–1941. (2015). https://doi.org/10.1128/JCM.00261-15
Russell, N. J. et al. Maternal Colonization With Group B Streptococcus and Serotype Distribution Worldwide: Systematic Review and Meta-analyses. Clin. Infect. Dis. 65 (suppl_2), S100–S111. https://doi.org/10.1093/cid/cix658 (2017).
Ding, Y., Wang, Y., Hsia, Y., Russell, N. & Heath, P. T. Systematic Review and Meta-Analyses of Incidence for Group B Streptococcus Disease in Infants and Antimicrobial Resistance, China. Emerg. Infect. Dis. 26 (11), 2651–2659. https://doi.org/10.3201/eid2611.181414 (2020).
Miller, S. A., Deak, E. & Humphries, R. Comparison of the AmpliVue, BD Max System, and illumi gene Molecular Assays for Detection of Group B Streptococcus in Antenatal Screening Specimens. Richter SS, ed. J Clin Microbiol. ;53(6):1938–1941. (2015). https://doi.org/10.1128/JCM.00261-15
Costa, S. C. et al. Group B Streptococcus rectovaginal colonization screening on term pregnancies: culture or polymerase chain reaction? J. Matern Fetal Neonatal Med. 36 (2), 2262078. https://doi.org/10.1080/14767058.2023.2262078 (2023).
Le Doare, K. et al. Uncertainties in Screening and Prevention of Group B Streptococcus Disease. Clin. Infect. Dis. 69 (4), 720–725. https://doi.org/10.1093/cid/ciy1069 (2019).
Van Du, V. et al. Antimicrobial resistance in colonizing group B Streptococcus among pregnant women from a hospital in Vietnam. Sci. Rep. 11 (1), 20845. https://doi.org/10.1038/s41598-021-00468-3 (2021).
Kamińska, D. et al. Macrolide and lincosamide resistance of Streptococcus agalactiae in pregnant women in Poland. Sci. Rep. 14 (1), 3877. https://doi.org/10.1038/s41598-024-54521-y (2024).
HajiAhmadi, P., Momtaz, H. & Tajbakhsh, E. Molecular characterization of Streptococcus agalactiae strains isolated from pregnant women. Sci. Rep. 15 (1), 5887. https://doi.org/10.1038/s41598-025-86565-z (2025).
Van, J. C. N. Implementing Point-of-Care Testing in Infectious Diseases. Clin Infect. Dis Published online November. 27 https://doi.org/10.1093/cid/ciaf650 (2025).
Acknowledgements
The authors would like to thank Xu Zheng and Cheng Li for their kindly help in technical assistance. Furthermore, we thank Shoufeng Zhao for her selfless help.
Funding
This work was supported by National Natural Science Foundation of China (No.32500126) and research projects Foundation of Qingdao Municipal Hospital.
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XCW and JSY designed the study; XCW, KZ and SZ performed the experiments; XCW and NNW analyzed the data; JYW, KZ and NNW participated in the clinical specimen detection. XCW and JSY wrote the manuscript. JYW and KZ revised the manuscript. All authors have read the manuscript and approved to submit to this journal.
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Wang, X., Wang, N., Wang, J. et al. Evaluation of a sensitivity real-time PCR assay for Group B Streptococcus detection in vaginal-rectal swab. Sci Rep (2026). https://doi.org/10.1038/s41598-026-42326-0
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DOI: https://doi.org/10.1038/s41598-026-42326-0