- 期刊
圍產期孕婦產前檢查B群鏈球菌（Group B Streptococcus）的簡易高效快檢技術
An Effective, Rapid and High-throughput Test for Detection of Group B Streptococcus in Specimens from Preterm Pregnant Women
摘要
B群鏈球菌（Group B Streptococcus, Streptococcus agalactiae, GBS）的運送增菌培養管（CMP^(TM) GBS TransCultSwab）與β／γ GBS detection agar（β／γ偵測瓊脂）／GBS carrot agar（GBS胡蘿蔔瓊脂）分隔平板（bi-plate）為針對孕婦產前檢查GBS所設計的快檢套組（試劑盒）。為了瞭解套組的效能，吾等將其實際應用於臨床GBS的檢驗，從2016年4月1日～2017年3月31日止，共檢測744個孕婦產前檢查檢體，操作時，先以GBS TransCultSwab採檢孕婦產道及（或）直腸之分泌物，以室溫或恆溫（35℃）暫時保存，然後運送至檢驗室後，置入35℃的一般或CO_2恆溫箱，約5～24小時後移種至分隔平板，以三區劃線法接種及插種，接著，將運送管及分隔平板放在35℃的一般或CO_2恆溫箱培養20～48小時後判讀，結果發現GBS檢出率為24.32％（181／744），檢驗室所花費的移種時間約為15秒／檢體，肉眼觀察GBS carrot agar上的菌落，若呈橘色～紅色，且在β／γ GBS detection agar呈現β-溶血現象，即可鑑定為GBS，並直接用於操作藥敏試驗；另外，GBS的型菌株（約佔3~5%）則可利用β／γ GBS detection agar上的β-溶血菌落配合傳統CAMP（Christie, Atkins, and Munch-Petersen）試驗或MALDI-TOF MS進行確認。總之，此GBS簡易高效快檢套組的臨床應用，將可簡化GBS檢測的操作流程、提升檢出率、縮短報告時間以及降低操作人力，係檢測GBS的高效工具，可協助產科醫師早期預防新生兒及孕婦的GBS感染。
並列摘要
The combination of CMP^(TM) GBS Trans CultSwab and a bi-plate containing β/γ GBS detection agar and GBS carrot agar is designed to be used for the detection of Group B Streptococcus (GBS, Streptococcus agalactiae) in specimens from preterm pregnant women. The GBS TransCultSwab is used for specimen collection, transport, and GBS enrichment, and the bi-plate is used for rapid identification of GBS. In this test, GBS produces colonies with orange to red color on GBS carrot agar and exhibit -hemolysis on β/γ GBS detection agar. To determine the efficacy of this GBS diagnostic kit, we tested a total of 744 vaginal/rectal specimens from preterm pregnant women from April 1, 2016 to March 31, 2017. The cotton swab in the GBS TransCultSwab envelope was used to collect vaginal/rectal secretions; it was then inserted into the TransCultSwab tube, which contains enrichment medium. The tube was transiently kept at 20~35℃ and then transported to laboratory and incubated in a 35℃, ambient or CO_2 incubator for 5-24 hours. The swab of the GBS TransCultSwab was then used to inoculate the specimen on each section of the bi-plate using the three-phase streaking technique. Both the GBS TransCultSwab and the inoculated biplate were incubated in a 35℃, CO_2 incubator for 20~48 hours. Results showed a GBS detection rate of 24.32% (181/744). The time required for inoculation was around 15 seconds per specimen. GBS was identified if orange-red colonies appeared on the GBS carrot agar with -hemolysis on the β/γ GBS detection agar. The colonies were then subjected to antimicrobial susceptibility test. γ-GBS (account for 3~5% of GBS) was identified if the colony showed β-hemolysis on the β/γ GBS detection agar and was positive for the CAMP (Christie, Atkins, and Munch-Petersen) test or MALDI-TOF MS test. Results of this study indicate that the combination of GBS TransCultSwab and bi-plate is an effective, rapid, and high-throughput GBS diagnostic tool. It would allow earlier medication of pregnant women to prevent neonates from GBS infections.