False-Negative Urine Latex Particle Agglutination Testing in Neonates With Group B Streptococcal Bacteremia: A Function of Improper Test Implementation?

Although blood cultures remain the most specific indicator of Group B streptococcus (GBS) sepsis, a potentially life-threatening infection in neonates, test results may not be available for 24 to 48 hours. Detection of GBS antigen in the urine by latex particle agglutination (LPA) may speed diagnosi...

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Bibliographic Details
Published in:Clinical pediatrics 1993-08, Vol.32 (8), p.467-471
Main Authors: Becker, Jeffrey A., Ascher, David P., Mendiola, Joe, Yoder, Brad, Weisse, Martin, Waecker, Norman, Heroman, William M., Davis, Charles, Fajardo, J.E., Fischer, Gerald W.
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antigens, Bacterial - blood
Antigens, Bacterial - urine
Bacteremia - classification
Bacteremia - immunology
Bacteremia - urine
Biological and medical sciences
Emergency and intensive care: neonates and children. Prematurity. Sudden death
False Negative Reactions
Female
Humans
Infant, Newborn
Intensive care medicine
Latex Fixation Tests - methods
Male
Medical sciences
Risk Factors
Sensitivity and Specificity
Streptococcal Infections - blood
Streptococcal Infections - classification
Streptococcal Infections - immunology
Streptococcal Infections - urine
Streptococcus agalactiae - immunology
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Summary:Although blood cultures remain the most specific indicator of Group B streptococcus (GBS) sepsis, a potentially life-threatening infection in neonates, test results may not be available for 24 to 48 hours. Detection of GBS antigen in the urine by latex particle agglutination (LPA) may speed diagnosis. This study analyzed the sensitivity of the GBS urine LPA assay under clinical conditions. The urine of neonates with early-onset GBS bacteremia was analyzed for GBS antigen over a three-year period at six military medical centers. Overall, 53.5% (38/71) of infants with positive blood cultures had a positive urine LPA test. Only one medical center routinely followed manufacturer's recommendations to concentrate urine specimens before testing. These data suggest that the sensitivity for the urine LPA assay, when performed on unconcentrated urine, is lower than previously reported. Clinicians should insist that the laboratory maximize sensitivity by concentrating urine prior to GBS LPA testing.
ISSN:0009-9228
1938-2707
DOI:10.1177/000992289303200805