Rapid tests for detecting group B streptococcus colonization in pregnant women: A systematic review and meta-analysis of diagnostic accuracy.
Edgar Páez-Castellanos, Alvaro Javier Burgos-Cárdenas, Hernando Gaitán-Duarte et al.
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In 30 seconds
This systematic review and meta-analysis assessed the diagnostic accuracy of rapid nucleic acid amplification tests without prior enrichment for detecting group B Streptococcus colonization in pregnant women. Across 52 studies involving 24,653 participants, pooled qPCR sensitivity was 90% (95% CI: 88%-92%) and specificity was 96% (95% CI: 95%-97%). For LAMP-based testing, sensitivity was 92% (95% CI: 84%-97%) and specificity was 96% (95% CI: 94%-98%). The authors judged evidence for qPCR sensitivity low-certainty and for LAMP sensitivity very low-certainty; specificity evidence was moderate-certainty for both.
Key findings
- Across 52 studies and 24,653 participants, median colonization prevalence was 21.4%.
- Rapid qPCR tests had 90% sensitivity (95% CI: 88%-92%) and 96% specificity (95% CI: 95%-97%).
- The LAMP-based test had 92% sensitivity (95% CI: 84%-97%) and 96% specificity (95% CI: 94%-98%).
- Subgroup analyses found no statistically significant differences by study entry status, sample source, or delivery-room processing (P = 0.19, P = 0.43, and P = 0.44).
Why it matters
Accurate rapid detection of maternal GBS colonization could inform screening where timely results are needed. The pooled estimates suggest high specificity for both test approaches, but uncertainty around sensitivity—particularly for LAMP—matters when interpreting a negative result. The review also highlights that evidence may not translate readily to intrapartum use or low- and middle-income settings.
What to keep in mind
The authors note limited applicability in intrapartum settings because of sample processing requirements and in low- and middle-income settings. Evidence certainty for sensitivity was low for qPCR and very low for LAMP.