Background

Testing for group B streptococcus (GBS) requires a vaginal-rectal swab in late pregnancy.

Objective

A systematic review of the test accuracy of a self-collected swab compared with a health-care professional collected swab in the diagnosis of GBS colonisation.

Search strategy

The Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects [DARE] and the Cochrane Central Register of Controlled Trials [CENTRAL]), EMBASE, MEDLINE and Trip were searched in May 2022.

Selection criteria

Randomised trials, test accuracy studies or diagnostic yield studies that compared the accuracy of a self-collected vaginal-rectal swab, compared to that taken by a health-care professional, for the detection of GBS colonisation in the third trimester.

Data collection and analysis

Two researchers independently screened, selected studies, extracted data and assessed study quality.

Main results

10 studies, with 2578 women were included. Pooled sensitivity of self-collected swabs was 0.90 (95% confidence interval [CI] 0.81 to 0.95) and pooled specificity was 0.98 (95% CI 0.96 to 0.99).

Conclusion

This study provides reassuring evidence that self-collected swabs for maternal GBS colonisation are highly accurate relative to swabs collected by health-care professionals. Women requiring a swab for GBS colonisation can self-swab with appropriate instructions if they choose.

Funding

Personal fellowship from the University of Nottingham for KFW.

中文翻译：

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自行采集与医疗保健专业人员采集的拭子用于鉴定妊娠晚期 B 族链球菌阴道-直肠定植：系统评价

背景

B 族链球菌 (GBS) 检测需要在妊娠晚期进行阴道直肠拭子检测。

客观的

对自行采集的拭子与医疗保健专业人员采集的拭子在 GBS 定植诊断中的测试准确性进行系统评价。

搜索策略

Cochrane 图书馆（包括 Cochrane 系统评价数据库、效果评价摘要数据库 [DARE] 和 Cochrane 对照试验中央注册库 [CENTRAL]）、EMBASE、MEDLINE 和 Trip 于 2022 年 5 月进行了检索。

选择标准

随机试验、测试准确性研究或诊断率研究，将自行采集的阴道直肠拭子与医疗保健专业人员采集的拭子进行比较，以检测妊娠晚期 GBS 定植的准确性。

数据收集与分析

两名研究人员独立筛选、选择研究、提取数据并评估研究质量。

主要结果

纳入 10 项研究，涉及 2578 名女性。自行采集拭子的汇总敏感性为 0.90（95% 置信区间 [CI] 0.81 至 0.95），汇总特异性为 0.98（95% CI 0.96 至 0.99）。

结论

这项研究提供了令人放心的证据，表明与卫生保健专业人员收集的拭子相比，自行采集的孕产妇 GBS 定植拭子的准确性更高。需要拭子进行 GBS 定植的女性如果愿意，可以在适当的说明下自行进行拭子拭子。

资金

诺丁汉大学 KFW 个人奖学金。