Comment on "prenatal screening for group B streptococci".
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Adult↗
Biomedical subjects
V N Kelly
Publications and source records attributed to V N Kelly.
Evaluation of new Granada medium (modified) for the antenatal screening of group B streptococcus.
New Granada medium (NGM), modified by the substitution of trimethoprim for methotrexate, was compared to a selective Todd-Hewitt broth (NPC broth) and direct plating onto Edwards medium for assessment of genital carriage of group B streptococcus in pregnant women. Whilst NGM was found to be less sensitive (85%) than NPC broth (95%) and more sensitive than Edwards medium (67%), its use reduced the direct laboratory cost of screening by approximately 41% and also improved the time to report a result by 24 hrs.
Bacteriological Techniques↗
Is antenatal screening for syphilis worth while?
To ascertain the effectiveness of an antenatal screening programme for syphilis, a review of the seven-year period from 1981 to 1987, was made at The Royal Women's Hospital, Melbourne. In total, 35,103 patients were screened, with a biological false-positive rate of 0.3%. Serological evidence of treponemal infection occurred in 0.4% of patients, with 66% of this group being newly recognized cases. Eight (0.02%) cases were consistent serologically with early treponemal infection, although clinically all patients were asymptomatic at the time of detection. The outcome in infants was satisfactory in all cases where appropriate antibiotic therapy was instituted antenatally. In one case, which presented late at 32-weeks' gestation for the first antenatal visit, the result was a fetal death in utero. The post-mortem findings were compatible with a diagnosis of congenital syphilis. At an incidence of 0.02% for active maternal syphilis, and an over-all treponemal infection rate of 0.4%, the cost-effectiveness of antenatal screening is well-justified.
Cost-Benefit Analysis↗
Isolation of genital mycoplasmas from the blood of neonates and women with pelvic infection using conventional SPS-free blood culture media.
Standard blood culture media used in our laboratory were tested for their ability to support the growth of Mycoplasma hominis and Ureaplasma urealyticum. Small inocula (approximately 10 colony forming units per ml) of both organisms grew in diphasic tryptone soya medium but not in any of several media containing sodium polyanetholesulphonate (SPS) including a modified Schaedler broth (RWH anaerobic medium) and two BACTEC media (6B and 7D). Both organisms were inhibited even by very low concentrations of SPS but grew well in the Royal Women's Hospital (RWH) anaerobic medium when SPS was omitted. During a 22-month period, routine "blind" plating of the aerobic blood cultures on to mycoplasma agar resulted in isolation of M. hominis or U. urealyticum from 12 women with postpartum or postoperative pelvic infection, and from 3 neonates. Genital mycoplasmas represented 35% of significant isolates from adult blood cultures.
Adult↗