Cultures Of Streptococci Research Articles

Proteomics of Streptococcus gordonii within a model developing oral microbial community

BackgroundStreptococcus gordonii is one of several species that can initiate the formation of oral biofilms that develop into the complex multispecies microbial communities referred to as dental plaque. It is in the context of dental plaque that periodontal pathogens such as Porphyromonas gingivalis cause disease. We have previously reported a whole cell quantitative proteomics investigation of P. gingivalis in a model dental plaque community of S. gordonii, P. gingivalis, and Fusobacterium nucleatum. Here we report the adaptation of S. gordonii to the same model.Results1122 S. gordonii proteins were detected in S. gordonii control samples, 915 in communities with F. nucleatum, 849 with P. gingivalis, and 649 with all three organisms. Quantitative comparisons showed extensive proteome changes in association with F. nucleatum or P. gingivalis individually or both P. gingivalis and F. nucleatum together. The changes were species specific, though the P. gingivalis interaction may be dominant, indicated by large differences between the proteomes with F. nucleatum or P. gingivalis but limited changes between communities with P. gingivalis or both P. gingivalis and F. nucleatum. The results were inspected manually and an ontology analysis conducted using DAVID. Extensive changes were seen in nutrition pathways with increases in energy metabolism and changes in the resulting byproducts, while the acid and sugar repressed PTS (phosphoenolpyruvate dependent phosphotransferase system) sugar transport systems showed decreases. These results were seen across all the multispecies samples, though with different profiles according to the partner species. F. nucleatum association decreased proteins for the metabolic end products acetate and ethanol but increased lactate, the primary source of acidity from streptococcal cultures. P. gingivalis containing samples had a reduction in levels of proteins for ethanol and formate but increased proteins for both acetate and lactate production. The communities also showed increases in exopolysaccharide synthesis, amino acid biosynthesis, and oxidative stress protection and decreases in adhesion and transporter proteins.ConclusionThis study showed that S. gordonii demonstrates species specific responses during interactions with F. nucleatum or P. gingivalis. Extensive changes were seen in energy metabolism and byproduct production implicating nutrient transfer as an important community interaction.

PCR/RFLP-based allelic variants of streptokinase and their plasminogen activation potencies

PCR-restriction fragment length polymorphism (PCR/RFLP)-based analysis of β-domain variable region of streptokinase genes (sk) has previously identified 14 sk alleles (sk1-sk14) in group A (GAS), C (GCS) and G (GGS) streptococci isolates from a few geographically distinct regions. However, the relation of sk allelic variants to their plasminogen activation potencies remained as a matter of debate. Herein, employing the same PCR/RFLP assay, we analysed sk allelic variants of GAS and GCS/GGS isolates from Iranian patients. In total, 21 sk allelic variants including 14 new alleles (sk14-sk28) were identified. Results implied the horizontal gene transfer of sk fragments between GAS and GCS/GGS strains and did not prove the specificity of particular sk alleles to GCS/GGS or GAS groups. Measurement of streptokinase (SK) activity in streptococcal culture supernatants by colorimetric assay (S2251 substrate) ranged from 9 to 182 IU mL(-1). Although some strains with the highest SK activity were detected in definite variants, no significant correlation between sk alleles and plasminogen activation was detected (P value > 0.05). Analysis of DNA sequences and restriction site mapping of selective sk variants with similar SK activity pointed to the inadequacy of the currently available PCR/RFLP method for differentiation of critical/silent nucleotides to precisely categorize sk alleles for their functional properties.

Bacteremic Pneumococcal Community-acquired Pneumonia in Children Less Than 5 Years of Age in Italy

This study was designed to determine the proportion of bacteremic pneumococcal cases in a group of pediatric subjects with community-acquired pneumonia (CAP), the importance of the different serotypes and the impact of the currently available pneumococcal conjugate vaccines (PCVs). The study involved children who were ≤5 years with radiographically confirmed CAP admitted to hospital in Italy between September 2008 and March 2011. A diagnosis of laboratory-confirmed bacteremic pneumococcal CAP was made in the presence of a culture and/or real-time polymerase chain reaction (PCR) positive for Streptococcus pneumoniae. A total of 510 children were included in the study. Pneumococcal CAP was diagnosed in 73 cases (14.3%): S. pneumoniae was identified by means of positive real-time PCR in 67 cases (91.8%), a positive blood culture in 1 (1.4%) and both in 5 (6.8%). Complicated pneumonia was observed significantly more often in the pneumococcal-positive cases (P=0.02) and empyema was the main complication (P=0.007). Serotype 19A was most frequently encountered (17 cases; 25.8%), followed by serotypes 14 (10 cases, 15.1%), 4 (5 cases, 7.6%) and 3 (4 cases, 6.1%). The theoretical coverage offered by the available PCVs was calculated to be 31% for PCV7, 37% for PCV10 and 71% for PCV13. In Italy, bacteremic pneumococcal CAP accounts for a significant number of CAP cases in children who were ≤5 years, with serotypes 19A and 14 being the most frequent. This suggests that PCV13 is the best means of preventing pneumococcal CAP.

Molecular analysis of the glutamate decarboxylase locus in Streptococcus thermophilus ST110

γ-aminobutyric acid (GABA) is generated from glutamate by the action of glutamic acid decarboxylase (GAD) and characterized by hypotensive, diuretic, and tranquilizing effects in humans and animals. The production of GABA by lactic acid starter bacteria would enhance the functionality of fermented dairy foods including cheeses and yogurt. The survey of 42 strains of the yogurt starter culture Streptococcus thermophilus by PCR techniques indicated the presence of a glutamate decarboxylase gene (gadB) in 16 strains. DNA sequencing data indicated that the GAD/GABA antiporter locus (gadB/gadC) in GAD(+) S. thermophilus strains is flanked by transposase elements (5' and 3') and positioned between the luxS (5') and the HD-superfamily hydrolase genes (3'). The PCR amplification product of a ca. 2-kb genomic fragment that included the gadB and its putative promoter region was inserted into a shuttle vector, which was used to transform Escherichia coli DH5α. Subsequently, the recombinant plasmid pMEU5a-1/gadB (7.24 kb) was electrotransformed into the GAD-negative strain S. thermophilus ST128. The ST128 transformants carrying the plasmid-encoded gadB produced functional GAD enzyme as evidenced by the conversion of glutamate to GABA at a rate similar to strains with the gadB/gadC operon located on the chromosome. The results demonstrated the potential to impart to non-GABA-producing strains of S. thermophilus and other lactic acid bacteria the GAD(+) phenotype that improves their appeal in possible applications in the development of health-promoting functional foods.

Cytological diagnosis of endometritis in the mare: Investigations of sampling techniques and relation to bacteriological results

Aim of this study was to compare uterine smears made using the Knudsen catheter, the cytology brush and a uterine culture swab with regard to diagnostic usefulness and the occurrence of neutrophils. Additionally correlation between culture results and the occurrence of neutrophils in uterine smears was investigated. Samples were collected from 340 mares, 81.5% of which were in estrus. Smears made using the cytology brush yielded more endometrial cells per high-power field than those made using the other two instruments (p<0.0001), and a larger proportion had PMNs compared with smears made using the uterine swab (p<0.0001). For smears made with the cytology brush, cultures of β-hemolytic streptococci were more often (p=0.002) accompanied by PMNs than cultures of bacteria other than β-hemolytic streptococci, and there was a positive correlation (rs=0.2 p=0.01) between the number of PMNs in smears and the number of colonies of β-hemolytic streptococci. The cytology brush was superior to the other methods because it generated a larger proportion of diagnostic useful smears and the occurrence of PMNs in smears was significantly correlated with the occurrence of cultures of β-hemolytic streptococci.

Технология производства сыра "Спартанский" из обезжиренного молока

Установлено, что использование в технологии изготовления сыра "Спартанский" в качестве сырья обезжиренного молока и закваски из чистых культур молочнокислых стрептококков в количестве 1 - 3 % способствует улучшению химического состава и биологической полноценности белка, а также микробиологических показателей опытного образца.

Exogenous group G Streptococcus endophthalmitis following intravitreal ranibizumab injection

We report a case of group G Streptococcus endophthalmitis following an intravitreal ranibizumab injection for a choroidal neovascular membrane. Pars plana vitrectomy was applied for endophthalmitis and group G Streptococcus cultures were isolated in the vitreous samples taken from the patient. Twenty-four hours following pars plana vitrectomy the patient underwent myocardial infarction and cardiac arrest. To our knowledge this is the first reported case of group G Streptococcus endophthalmitis following an intravitreal injection.

Eyelids Necrotizing Fasciitis in Children

Purpose: Two cases of eyelids Necrotizing Fasciitis in children were presented. The first one with chicken pox, and the second was previously healthy.Design: Interventional Report cases. Methods: Two cases of eyelids Necrotizing Fasciitis in children were studied. The first case was a 7 years old girl who presented a necrotizing fasciitis in superior and inferior eyelids with a serious toxic shock as a complication of the chicken pox. Parenteral antibiotic treatment was not enough to stop the necrotizing process and surgical debriding was needed for the gangrenous tissues. In the eyelid culture Streptococcus pyogenes grew. A free skin graft was implanted to the inferior eyelid. The second case was presented in a 6 months old girl, who developed necrotizing fasciitis of her lower left eyelid without any trauma antecedent. The ocular and blood cultures did not show any microorganism growth. An appropriate antibiotic coverage and management of systemic manifestations leads to a fast recovering; even though the developed necrosis demanded surgical debriding and a retroauricular free skin graft was performed later.

Effect of milk protein glycation and gastrointestinal digestion on the growth of bifidobacteria and lactic acid bacteria

In this paper, β-lactoglobulin (β-Lg) and sodium caseinate (SC) have been glycated via Maillard reaction with galactose and lactose and, subsequently, the effect of glycoconjugates hydrolyzed under simulated gastrointestinal digestion on the growth of pure culture of Lactobacillus, Streptococcus and Bifidobacterium has been investigated. Glycopeptides were added to the growth media as the sole carbon source. None of the bacterial strains was able to grow in hydrolysates of native and control heated β-Lg and SC. However, glycopeptides were fermented, in different degree, by Lactobacillus and Bifidobacterium and hardly any effect was detected on the growth of Streptococcus. Digested β-Lg glycoconjugates showed a strain-dependent effect whereas growth profiles of bacteria when hydrolysates of SC glycoconjugates were used as substrates were very similar, regardless of the strain. A general preference towards peptides from β-Lg/SC glycated with galactose, particularly at the state of the reaction in which the highest content in the Amadori compound tagatosyl-lysine is present, was observed. SC glycoconjugates were quickly fermented by some strains, promoting their growth in a greater extent than β-Lg complexes or even glucose. Therefore, from the results obtained in this work it can be concluded that conjugation of both milk proteins with galactose and lactose via the Maillard reaction could be an efficient method to obtain novel food ingredients with a potential prebiotic character.

A Multiplex Polymerase Chain Reaction Assay for Direct Detection and Differentiation of β-Hemolytic Streptococci in Clinical Samples from Horses

Streptococcus equi subspecies equi, S equi subspecies zooepidemicus, and S dysgalactiae subspecies equisimilis are β-hemolytic Streptococci, often isolated from horses with respiratory or genital diseases. The aim of this study was (i) defining and validating a multiplex polymerase chain reaction (PCR) protocol for identifying these Streptococci in bacterial cultures and for detecting them directly in equine clinical specimens, and (ii) defining and validating a cheap DNA extraction protocol for clinical specimens. When respiratory and genital samples from symptomatic and asymptomatic horses were tested by bacterial culture and by multiplex PCR, all the 150 samples culture-positive for S equi, S zooepidemicus, or S equisimilis were also positive by PCR. Of 150 culture-negative samples, 143 were negative by PCR. Seven samples were positive by PCR but negative by bacteriology. The multiplex PCR protocol described in this study is proven suitable for a sensitive, specific, and rapid detection and identification of S equi, S zooepidemicus, and S equisimilis in cultured bacterial colonies, as well as in clinical specimens from symptomatic or asymptomatic horses. The inclusion of internal control primers in the PCR protocol excludes false-negative results. A cheap DNA extraction method has been also validated for swabs, tracheal aspirates, bronchoalveolar lavage, and guttural pouches lavage samples.

Proteolysis Characterization of Low- and Full-Fat Cheese Fermented by Lactobacillus acidophilus during Ripening Process

Abstract. Low- and full-fat cheeses were fermented by Lactobacillus acidophilus and adjunct cultures Streptococcus thermophilus. After ripening for 90d at 4°C, the protein had been proteolysed in different degrees. The results showed that protein content of low- and full-fat cheese were all decreased after 90 d ripened, which the low-fat cheese was 40.45% and full-fat cheese was 28.68%. The soluble nitrogen contents at pH 4.6 (pH 4.6 SN) were 4.97% and 3.88%, and 12% (w/v) trichloracetic acid soluble nitrogen (12% TCA-SN) were 5.17% and 3.74% in low- and full-fat cheese respectively. After ripening for 90d at 4°C it was found that a part of protein in cheese were degraded into amino acids determined by automatic amino acid analyzer, total amino acids contents in low- and full-fat cheese were 29.17 mg•100g-1 and 16.02 mg•100g-1, respectively.

Serum levels of anti‐streptolysin O antibodies: their role in evaluating rheumatic diseases

Family physicians measure serum levels of anti-streptolysin O antibodies (ASO) in the routine evaluation of patients with rheumatic conditions. To evaluate the significance of elevated serum ASO titer in hospitalized patients with various clinical conditions. We retrieved the names of all patients in whom ASO serum titer was tested in our hospital during two successive years. We chose only those with titers of 1 : 160 or greater (cut-off level < 1 : 80) or with no titer. Their charts were reviewed and the causes for their hospitalization and the reasons for requesting the tests were identified. We also measured the ASO serum titer in 60 healthy individuals. Six hundred and twenty-five patients were tested for ASO serum levels; 129 patients were negative. In 291 (44%) patients tests were positive at low titers (< 1 : 160). In 205 (33%) the serum titers of ASO were ≥ 1 : 160. We analyzed two groups: those with high ASO titers (≥ 1 : 160) (group 1) and those who were negative for this test (group 2). In group 1, streptococcal cultures were positive only in 14% of the patients with elevated ASO. There was no correlation between ASO serum levels and erythrocyte sedimentation rate, C-reactive protein or rheumatoid factor. In only five individuals (8%) of the healthy cohort, was ASO significantly elevated. Elevated ASO titers can be found in various clinical conditions other than the typical post-streptococcal associated diseases. In these cases it is not necessarily accompanied by positive culture and does not correlate with inflammatory parameters.

Immunity to pneumococcal surface proteins in children with community-acquired pneumonia: a distinct pattern of responses to pneumococcal choline-binding protein A

The aetiological diagnosis of community-acquired pneumonia (CAP) is challenging in children, and serological markers would be useful surrogates for epidemiological studies of pneumococcal CAP. We compared the use of anti-pneumolysin (Ply) antibody alone or with four additional pneumococcal surface proteins (PSPs) (pneumococcal histidine triad D (PhtD), pneumococcal histidine triad E (PhtE), LytB, and pneumococcal choline-binding protein A (PcpA)) as serological probes in children hospitalized with CAP. Recent pneumococcal exposure (positive blood culture for Streptococcus pneumoniae, Ply+ blood PCR finding, and PSP seroresponse) was predefined as supporting the diagnosis of presumed pneumococcal CAP (P-CAP). Twenty-three of 75 (31%) children with CAP (mean age 33.7 months) had a Ply+ PCR finding and/or a ≥2-fold increase of antibodies. Adding seroresponses to four PSPs identified 12 additional patients (35/75, 45%), increasing the sensitivity of the diagnosis of P-CAP from 0.44 (Ply alone) to 0.94. Convalescent anti-Ply and anti-PhtD antibody titres were significantly higher in P-CAP than in non P-CAP patients (446 vs. 169 ELISA Units (EU)/mL, p 0.031, and 189 vs. 66 EU/mL, p 0.044), confirming recent exposure. Acute anti-PcpA titres were three-fold lower (71 vs. 286 EU/mL, p <0.001) in P-CAP children. Regression analyses confirmed a low level of acute PcpA antibodies as the only independent predictor (p 0.002) of P-CAP. Novel PSPs facilitate the demonstration of recent pneumococcal exposure in CAP children. Low anti-PcpA antibody titres at admission distinguished children with P-CAP from those with CAP with a non-pneumococcal origin.

Analysis of Main Flavor Substances of Low- and Full-Fat Cheese Fermented by &lt;i&gt;Lactobacillus acidophilus&lt;/i&gt; during Ripening Process

Low- and full-fat cheeses were fermented by Lactobacillus acidophilus and adjunct cultures Streptococcus thermophilus. After ripening for 90d at 4°C, the main flavor substances were determined by gas chromatograph. The results showed that more than 28 main flavor components were founded in full-fat cheese, and at least 19 were founded in low-fat cheese. In low-fat cheese, there was a higher content of 9-(Z)- octadecenoic acid and 10-hydroxy-octanoic acid methyl ester, which their relative mass fraction were 19.20% and 18.79% respectively. In full-fat cheese, there was a higher content of hexadecanoic acid methyl ester and 9-Octadecenoic acid(Z)-methyl ester, which their relative mass fraction were 24.27%and 23.37% respectively.

Erratum to: Biopreservation of Sardinella longiceps and Penaeus monodon Using Protective Culture Streptococcus phocae PI 80 Isolated from Marine Shrimp Penaeus indicus.

The influence of Streptococcus phocae PI80 on the shelf life of Sardinella longiceps and Penaeus monodon was investigated by measurement of microbial and chemical analysis after appraising the safety of the protective probiotic culture in wistar rat’s model. The results of this safety assessment indicate that oral administration of protective culture does not demonstrate any toxicological effects. Consumption of this LAB strain had no adverse effects on animal’s general health status, hematology, blood biochemistry, histology parameters, or on the incidence of bacterial translocation. The effect of Streptococcus phocae is very evident with the reduction of Listeria monocytogenes, Vibrio parahemolyticus, and coliforms. During storage, a marked decline in total volatile base and peroxide value was observed in protective culture-treated samples than the control. This strain looks promising as a protective culture for the preservation of fish products.

Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types

We describe associations between death from invasive pneumococcal disease (IPD) and particular serogroups and sequence types (STs) determined by multilocus sequence typing (MLST) using data from Scotland. All IPD episodes where blood or cerebrospinal fluid (CSF) culture isolates were referred to the Scottish Haemophilus, Legionella, Meningococcal and Pneumococcal Reference Laboratory (SHLMPRL) from January 1992 to February 2007 were matched to death certification records by the General Register Office for Scotland. This represented 5959 patients. The median number of IPD cases in Scotland each year was 292. Deaths, from any cause, within 30 days of pneumococcal culture from blood or CSF were considered to have IPD as a contributing factor. Eight hundred and thirty-three patients died within 30 days of culture of Streptococcus pneumoniae from blood or CSF [13.95 %; 95 % confidence interval (13.10, 14.80)]. The highest death rates were in patients over the age of 75. Serotyping data exist for all years but MLST data were only available from 2001 onward. The risk ratio of dying from infection due to particular serogroups or STs compared to dying from IPD due to all other serogroups or STs was calculated. Fisher’s exact test with Bonferroni adjustment for multiple testing was used. Age adjustment was accomplished using the Cochran–Mantel–Haenszel test and 95 % confidence intervals were reported. Serogroups 3, 11 and 16 have increased probability of causing fatal IPD in Scotland while serogroup 1 IPD has a reduced probability of causing death. None of the 20 most common STs were significantly associated with death within 30 days of pneumococcal culture, after age adjustment. We conclude that there is a stronger association between a fatal outcome and pneumococcal capsular serogroup than there is between a fatal outcome and ST.

Legal Briefs

A 3,260-g, 38 weeks' gestation, appropriate-for-gestational age male infant is delivered to a mother whose pregnancy was complicated by gestational diabetes for which she took glyburide. Group B streptococcal cervical culture was negative. Oxytocin was started because of ineffective labor. A cesarean section was performed because the fetus became intolerant of labor. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. The physical examination yielded normal results, and the baby was sent to room-in with his mother. During the first 24 hours after birth, the infant's glucose was measured by point-of-care strip five times, with results ranging from 45 to 66 mg/dL (2.5 to 3.7 mmol/L). The mother repeatedly complained to the nurses that the infant was sleepy at the breast and not nursing. A lactation specialist worked with the mother, but the baby still did not nurse. The mother requested formula, and the infant took four feedings of 35 to 66 mL during this first 24-hour period. The infant voided one time but did not stool. His weight loss at approximately 24 hours was 7.8%. This weight loss was neither brought to the physician's attention nor addressed by the physician on morning rounds. During the next 24-hour period, the infant continued to be sleepy at the breast and did not latch, according to the mother. The nurses wrote in their notes the duration of time that the baby was “placed at the breast,” but other details such as latching and audible swallow were absent. The mother fed the infant formula twice (40 mL and 60 mL) during this period. He voided three times but did not stool. At 52 hours of age, the infant had lost 10.4% of his weight since birth. The nurse informed the mother of this weight loss. The mother attempted feeding, but …

Predicting In Vitro Antibacterial Efficacy across Experimental Designs with a Semimechanistic Pharmacokinetic-Pharmacodynamic Model

We have previously described a general semimechanistic pharmacokinetic-pharmacodynamic (PKPD) model that successfully characterized the time course of antibacterial effects seen in bacterial cultures when exposed to static concentrations of five antibacterial agents of different classes. In this PKPD model, the total bacterial population was divided into two subpopulations, one growing drug-susceptible population and one resting drug-insensitive population. The drug effect was included as an increase in the killing rate of the drug-susceptible bacteria with a maximum-effect (E(max)) model. The aim of the present study was to evaluate the ability of this PKPD model to describe and predict data from in vitro experiments with dynamic concentration-time profiles. Dynamic time-kill curve experiments were performed by using an in vitro kinetic system, where cultures of Streptococcus pyogenes were exposed to benzylpenicillin, cefuroxime, erythromycin, moxifloxacin, or vancomycin using different starting concentrations (2 and 16 times the MIC) and elimination conditions (human half-life, reduced half-life, and constant concentrations). The PKPD model was applied, and the observations for the static as well as dynamic experiments were compared to model predictions based on parameter estimation using (i) static data, (ii) dynamic data, and (iii) combined static and dynamic data. Differences in experimental settings between static and dynamic experiments did not affect the growth kinetics of the bacteria significantly. With parameter reestimation, the structure of our previously proposed PKPD model could well characterize the bacterial growth and killing kinetics when exposed to dynamic concentrations with different elimination rates of all five investigated antibiotics. Furthermore, the model with parameter estimates based on data from only the static time-kill curve experiments could predict the majority of the time-kill curves from the dynamic experiments reasonably well. Adding data from dynamic experiments in the estimation improved the model fit for cefuroxime and vancomycin, indicating some differences in sensitivity to experimental conditions among the antibiotics studied.

PNEUMOCOCCAL BACTEREMIA IN FEBRILE INFANTS PRESENTING TO THE EMERGENCY DEPARTMENT 8 YEARS AFTER THE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINE IN THE BASQUE COUNTRY OF SPAIN

We included 3088 well-appearing infants aged between 3 and 36 months with fever without a source with a blood culture done as part of their study of fever. Rate of positive blood cultures for Streptococcus pneumoniae occult bacteremia (OB) was 0.58%. Rate of OB caused by PCV7-serotypes and nonvaccine serotypes were 0.16% and 0.42%, respectively. A total of 18 cases of S. pneumoniae OB were identified between January 1, 2006 and December 31, 2009. None of the 5 infants who had S. pneumoniae OB caused by vaccine serotypes had received PCV7. The decline in pneumococcal OB rates observed after PCV7 introduction in our area (Basque Country, Spain) continues 8 years later. There is no evidence of an OB rate increase caused by non-PCV7 serotypes.

The Accuracy of Late Third-Trimester Antenatal Screening for Group B Streptococcus in Predicting Colonization at Delivery

We reevaluated the accuracy of antenatal group B streptococcal (GBS) culture results in predicting colonization at the time of delivery in a general practice setting. Patients who had late third-trimester antenatal GBS cultures were prospectively identified. A repeat GBS culture was performed when admitted in labor using a strict protocol and laboratory analysis. Sensitivity, specificity, and positive and negative predicative values were calculated. In comparing the office culture results to the intrapartum cultures in 1472 patients, the sensitivity was 51%, specificity 94%, positive predictive value 67%, and negative predictive value 88%. The antenatal positive culture rate of 15.4% was significantly lower than the 20.1% intrapartum positive culture rate. There were 144 patients (9.8%) who had false-negative antenatal culture results. Through office survey, several aspects of the recommended antenatal procedures were not followed. The results support the previously reported high specificity and negative predictive values for this test. The near 10% false-negative rate with the significant difference between the antenatal versus intrapartum positive culture rate highly suggests that late third-trimester culture accuracy may be affected if the specified procedures are not completely followed, including the culturing technique, the use of recommended transport medium, and the laboratory culture protocol.