Evaluation of Amniotic Fluid for Aerobic and Anaerobic Bacteria

Lewis, Jay F.; Johnson, Peggy A.; Miller, P H

doi:10.1093/ajcp/65.1.58

Cited by 38 publications

(17 citation statements)

References 6 publications

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“…amniotic-fluid to be 'latent intrauterine infection' [15]. The present study demonstrated that elastase levels in amniotic fluid were strongly correlated with intrauterine infections and neonatal infections.…”

Section: Discussionsupporting

confidence: 51%

Relationship between Granulocyte Elastase Levels and Perinatal Infections

Matsuda¹,

Maruyama²,

Kuraya³

1995

Gynecol Obstet Invest

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This study was conducted in order to investigate the usefulness of granulocyte elastase levels as predicitve factors in the onset of perinatal infections. The subjects were 41 patients who delivered within 48 h after amniocentesis after giving their informed consent. The relationship between cervical granulocyte elastase (Cx-E), serum C-reactive protein (CRP) and amniotic fluid granulocyte elastase (Af-E), and placental infections and neonatal infections was comparatively investigated. In some cases, gastric juice granulocyte elastase in neonates (Gj-E) was measured, and the correlation by site was investigated. Elastase levels were not used as a management protocol. In predicting neonatal infections, diagnostic efficacy (sensitivity × specificity) of placental infections (0.97) and abnormal Af-E (0.79) were superior to those of abnormal Cx-E (0.40) and abnormal CRP (0.49). There was no correlation between Cx-E and Af-E or between Cx-E and Gj-E; however, a very close correlation was noted between Af-E and Gj-E. In predicting abnormal amniotic fluids, Cx-E (≥1.2 µg/ml) + CRP (≥1.0 mg/dl) had the highest diagnostic efficacy with 0.58. These findings demonstrate that Af-E is a good index for predicting the onset of neonatal infections. In predicting abnormal amniotic fluid, it might be advisable to consider amniocentesis in order to diagnose intrauterine infections, when both Cx-E and CRP show abnormal levels.

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Section: Discussionsupporting

confidence: 51%

Relationship between Granulocyte Elastase Levels and Perinatal Infections

Matsuda¹,

Maruyama²,

Kuraya³

1995

Gynecol Obstet Invest

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“…Six patients had Lactobacillus spp., three had Sneathia , and other patients had Veillonella spp. All of these microorganisms have been previously identified in AF [51, 92, 132–135]. …”

Section: Discussionmentioning

confidence: 99%

Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques

Romero¹,

Miranda²,

Kusanovic³

et al. 2015

Journal of Perinatal Medicine

209

216

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Introduction The objectives of this study were: 1) to determine the amniotic fluid (AF) microbiology of patients with the diagnosis of clinical chorioamnionitis at term using both cultivation and molecular techniques; and 2) to examine the relationship between intra-amniotic inflammation with and without microorganisms and placental lesions consistent with acute AF infection. Methods The AF samples obtained by transabdominal amniocentesis from 46 women with clinical signs of chorioamnionitis at term were analyzed using cultivation techniques (for aerobic and anerobic bacteria as well as genital mycoplasmas) and broad-range polymerase chain reaction (PCR) coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). The frequency of microbial invasion of the amniotic cavity (MIAC), intra-amniotic inflammation [defined as an AF interleukin 6 (IL-6) concentration ≥ 2.6ng/mL], and placental lesions consistent with acute AF infection (acute histologic chorioamnionitis and/or acute funisitis) were examined according to the results of AF cultivation and PCR/ESI-MS as well as AF IL-6 concentrations. Results 1) Culture identified bacteria in AF from 46% (21/46) of the participants, whereas PCR/ESI-MS was positive formicroorganisms in 59% (27/46) – combining these two tests, microorganisms were detected in 61% (28/46) of patients with clinical chorioamnionitis at term. Eight patients had discordant test results; one had a positive culture and negative PCR/ESI-MS result, whereas seven patients had positive PCR/ESI-MS results and negative cultures. 2) Ureaplasma urealyticum (n = 8) and Gardnerella vaginalis (n = 10) were the microorganisms most frequently identified by cultivation and PCR/ESI-MS, respectively. 3) When combining the results of AF culture, PCR/ESI-MS and AF IL-6 concentrations, 15% (7/46) of patients did not have intra-amniotic inflammation or infection, 6.5% (3/46) had only MIAC, 54% (25/46) had microbial-associated intra-amniotic inflammation, and 24% (11/46) had intra-amniotic inflammation without detectable microorganisms. 4) Placental lesions consistent with acute AF infection were significantly more frequent in patients with microbial-associated intra-amniotic inflammation than in those without intra-amniotic inflammation [70.8% (17/24) vs. 28.6% (2/7); P = 0.04]. Conclusion Microorganisms in the AF were identified in 61% of patients with clinical chorioamnionitis at term; 54% had microbial-associated intra-amniotic inflammation, whereas 24% had intra-amniotic inflammation without detectable microorganisms.

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“…Infection and inflammation have previously been studied less stringently in term delivery tissues (13,(15)(16)(17)(18). Not all of these studies directly studied bacteria, but two studies in particular are of interest.…”

Section: Detection Of Organismsmentioning

confidence: 99%

“…A few studies have addressed this question (13,(15)(16)(17)(18), but there have been no recent rigorous investigations of this question. Some of these studies report chorioamnionitis, but the technology to identify bacteria was not available.…”

mentioning

confidence: 99%

Bacteria and Inflammatory Cells in Fetal Membranes Do Not Always Cause Preterm Labor

et al. 2005

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Intrauterine infection has been frequently linked with preterm labor before 30 wk of human pregnancy. Many different species of organisms have been detected, leading to the suggestion that infection-induced preterm labor is a generic inflammatory response to organisms rather than a specific response to a limited number of pathogens. The detection of organisms by microbiological culture is a laborious and unreliable process, so the aim of this study was to harness modern molecular techniques to detect organisms in tissues from human pregnancy. A DNA probe specific for conserved regions of bacterial 16S ribosomal RNA sequence was designed and labeled with fluorescein for fluorescence in situ hybridization. Organisms were detected in the great majority (Ͼ80%) of fetal membranes after prolonged premature rupture of the fetal membranes and after preterm labor, which was consistent with previous data. Organisms were also detected in fetal membranes after preterm delivery without labor and in term deliveries (with or without labour). Inflammatory cells were found frequently in the amnion or chorion of preterm fetal membranes but not in term tissues. Our primary finding is that fluorescence in situ hybridization is an appropriate method to detect organisms in human fetal membranes. In addition, our data show that bacteria may be present in fetal membranes without necessarily causing an inflammatory response, so the mere presence of bacteria may not be sufficient to cause preterm labor. Human labor at all gestational ages involves an inflammatory response, being characterized by increased levels of prostaglandins and cytokines (1,2). This inflammation is presumed to be initiated by physiological mediators, including corticotrophin-releasing hormone (3) or platelet-activating factor (4), or by pathological processes (5-7).At 23-32 wk of pregnancy, preterm labor is most frequently associated with micro-organisms within the uterus (8). These organisms are thought to activate inflammatory responses within intrauterine tissues and cause the recruitment of leukocytes to the fetal membranes (chorioamnionitis) (9,10). This is so thoroughly accepted that in some studies, chorioamnionitis has been used as being diagnostic of intrauterine infection, without determination of the presence of bacteria (11). However, the precise relation between the presence of bacteria and an inflammatory response has not been clearly defined. This is an important issue as it is not known whether the presence of bacteria always causes chorioamnionitis or whether chorioamnionitis is always linked to infection.Many different organisms have been identified from intrauterine tissues after preterm labor using various sampling and culture techniques (12-14), but no clear pattern has emerged from these studies, so it has not been possible to implicate one particular organism or family of organisms as the main causes of preterm labor. Furthermore, it has not been proved that the bacteria present in the vagina are those that have caused chorioamnionitis in pre...

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Evaluation of Amniotic Fluid for Aerobic and Anaerobic Bacteria

Cited by 38 publications

References 6 publications

Relationship between Granulocyte Elastase Levels and Perinatal Infections

Relationship between Granulocyte Elastase Levels and Perinatal Infections

Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques

Bacteria and Inflammatory Cells in Fetal Membranes Do Not Always Cause Preterm Labor

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