Patient preference for self-collected cultures for group B streptococcus in pregnancy.

To determine pregnant women's preference for self-culture technique, 251 women between 24 and 42 weeks' gestation were interviewed after performing self-collected cultures (vaginal and rectal) for group B streptococcus. Patient receptiveness to self-culture, the ability to perform self-culture, and the desire for choice in the future were derived using the Patient Preference Tool. The majority of women (77%, n = 194) gave positive descriptions of self-culture technique, and the majority of women preferred self-culture technique over nurse-collected sampling (57%, n = 142). Seventy-nine percent (n = 197) stated their desire to have a choice about self-culture in the future when similar testing was needed, and 89% (n = 224) believed that other women would also like this choice. Additionally, patient samples were highly correlated with nurse-collected samples for accuracy of culture results. This study provides data supporting that women desire active participation in their care.

The accuracy and patient preference for self-collected group B Streptococcus cultures.

OBJECTIVE: Our purpose was to determine the accuracy of and patient attitudes regarding self-collected group B Streptococcus cultures. STUDY DESIGN: Women seen for prenatal care at 24 to 42 weeks' gestation were asked to collect distal vaginal and anal samples for group B Streptococcus. Subsequently, distal vaginal and anal samples were obtained by the nurse. The patients were then asked their preference toward self-sampling. RESULTS: A total of 251 women participated in the study. The incidence of positive group B Streptococcus cultures was 12.7%, 9.6%, 10.0%, and 7.6% for the patient-collected vaginal and anal and nurse-collected vaginal and anal specimens, respectively. The incidence of group B Streptococcus carriage was 17.5% and 13.5% for any positive patient- or provider-collected specimens, respectively, and 19.1% for any positive culture. Single patient-collected vaginal and anal and nurse-collected vaginal and anal samples were insensitive for group B Streptococcus carriage (67%, 50%, 52%, 40%, respectively). The combination of patient-collected samples was more sensitive than nurse-collected samples (sensitivity 91.7% vs 70.8%, p < 0.05). Repeat sampling of the vagina or anal canal did not offer significant additional benefit to a single culture. Overall, patient-collected samples were 98.4% accurate in predicting group B Streptococcus carriage versus 94.4% for nurses. A total of 58% of women preferred obtaining their own specimens, whereas 9.6% found the technique difficult. Ninety percent desired the option of self-sampling in the future. CONCLUSIONS: Single vaginal or anal cultures were insensitive in detecting group B Streptococcus carriage. Combined patient-collected cultures were more sensitive than provider-collected specimens. On the basis of accuracy and patient preference, women should be given the opportunity of combined vaginal-anal self-sampling for group B Streptococcus when indicated.