Abstract

Group B Streptococcus (GBS) can be found to colonize about 25% of all healthy, adult women and is the leading infectious cause of early neonatal morbidity and mortality in the United States. This study evaluated the clinical performance of PhenoMatrix (PM) chromogenic detection module (CDM) digital imaging software in detection of GBS from LIM broth plated on ChromID Strepto B chromogenic medium (ChromID) using the WASP automated processor. The performance of the PM CDM was compared to manual culture review of the digital images and molecular detection of GBS. ChromID alone had a sensitivity and specificity of 84.5% and 94.7%, respectively, after 48 h compared to nucleic acid amplification testing (NAAT). Compared to the composite reference for positivity, when PM CDM was used to detect GBS from ChromID, the sensitivity was 100%, with no true-positive GBS isolates missed by 48 h of incubation. Overall, evaluating all three methods for the detection of GBS, the sensitivities of NAAT, ChromID plus PM CDM at 48 h, and ChromID alone at 48 h were 96.8%, 95.5%, and 90.3%, respectively. The specificities of NAAT, ChromID plus PM CDM, and ChromID alone were 97.7%, 63.0%, and 95.4%, respectively. The sensitivity of ChromID in combination with the PM CDM was similar to the sensitivity of molecular detection. Further, the algorithm never called a culture negative that was determined to be positive by manual reading, and it identified an additional eight true positive specimens that were missed by manual digital image culture reading.

Highlights

  • Group B Streptococcus (GBS) has been recognized as a leading cause of infectious early neonatal morbidity and mortality in the United States and around the world [1]

  • We evaluated the performance of the PM color detection module (CDM) software used with chromogenic medium (ChromID) Strepto B medium for GBS (ChromID GBS; bioMérieux, Durham, NC) for the detection of GBS in LIM broths compared to routine visual inspection and a molecular detection method

  • Compared to nucleic acid amplification testing (NAAT) alone, we observed a difference in specificity of ChromID GBS at 48 h (94.8%) and at 24 h (97.7%) (Table 1)

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Summary

Introduction

Group B Streptococcus (GBS) has been recognized as a leading cause of infectious early neonatal morbidity and mortality in the United States and around the world [1]. Use of selective or chromogenic medium has increased the sensitivity of culture. There are several commercially available NAATs for the detection of GBS that increase sensitivity, require less hands-on time, and provide a faster result, but they are often more expensive and may have slightly lower specificity than culture [9, 10]. The software can segregate urine culture plates according to whether they show growth, no growth, or insignificant growth, and the color detection module (CDM) can recognize and differentiate colony colors on chromogenic agars. Previous studies have described the ability of the PM CDM software to increase the sensitivity and specificity of detection of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and group A Streptococcus using chromogenic media [12,13,14]. The technologists view these digital images for culture work-up, rather than handling the plates themselves

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