First Trimester Vaginal &lt;b&gt;&lt;i&gt;Ureaplasma&lt;/i&gt;&lt;/b&gt; Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

Rittenschober-Böhm, Judith; Waldhoer, Thomas; Schulz, Stefan M.; Stihsen, Birgit; Pimpel, Birgit; Goeral, Katharina; Hafner, E.; Sliutz, Gerhard; Kasper, David C.; Witt, Armin; Berger, Angelika

doi:10.1159/000480065

Cited by 29 publications

(36 citation statements)

References 22 publications

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“…In contrast to E. coli, Ureaplasma spp. is a very low virulence common vaginal commensal with a prevalence of around 40% 59 and is the most common organism found in PTB. Our PTB rates of 28% are also similar to PTB rates reported in a retrospective study of women with a short cervix and intrauterine Ureaplasma spp.…”

Section: Discussionmentioning

confidence: 99%

Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice

et al. 2020

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Around 40% of preterm births are attributed to ascending intrauterine infection, and Ureaplasma parvum (UP) is commonly isolated in these cases. Here we present a mouse model of ascending UP infection that resembles human disease, using vaginal inoculation combined with mild cervical injury induced by a common spermicide (Nonoxynol-9, as a surrogate for any mechanism of cervical epithelial damage). We measure bacterial load in a non-invasive manner using a luciferase-expressing UP strain, and post-mortem by qPCR and bacterial titration. Cervical exposure to Nonoxynol-9, 24 h pre-inoculation, facilitates intrauterine UP infection, upregulates pro-inflammatory cytokines, and increases preterm birth rates from 13 to 28%. Our results highlight the crucial role of the cervical epithelium as a barrier against ascending infection. In addition, we expect the mouse model will facilitate further research on the potential links between UP infection and preterm birth.

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Section: Discussionmentioning

confidence: 99%

Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice

et al. 2020

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“…Some case–control studies have shown that the vaginal colonization with U. parvum , but not with U. urealyticum , is associated with late abortions or spontaneous preterm birth . The significant association between U. parvum colonization and spontaneous preterm birth was found to be independent of the presence of bacterial vaginosis or fungal infections .…”

Section: Genital Ureaplasma Infection and Preterm Birthmentioning

confidence: 98%

“…At an earlier gestational age, patients with pPROM reportedly have a higher percentage of vaginal colonization with Ureaplasma spp. and higher intensity of intra‐amniotic inflammatory response …”

Section: Genital Ureaplasma Infection and Preterm Birthmentioning

confidence: 99%

Current understanding and treatment of intra‐amniotic infection with Ureaplasma spp.

Tantengco

Yanagihara

2019

J of Obstet and Gynaecol

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Considerable evidence has shown that intra-amniotic infection with Ureaplasma spp. increases the risk of chorioamnionitis and preterm labor. Ureaplasma spp. are among the smallest organisms, and their isolation is uncommon in routine clinical practice because of their size and high auxotrophy. Although Ureaplasma spp. have been reported as causative agents of preterm birth, they also have a high incidence in vaginal swabs collected from healthy reproductive-age women; this has led to questions on the virulence of Ureaplasma spp. and to them being considered as harmless commensal bacteria. Therefore, many efforts have been made to clarify the pathogenicity of Ureaplasma spp. at the molecular level. Ureaplasma spp. are surrounded by lipoproteins, including multiple-banded antigen. Both multiple-banded antigen and its derivative, that is, the synthetic lipopeptide, UPM-1, induce an inflammatory response in a preterm mice model, which was adequate to cause preterm birth or stillbirth. In this review, we present an overview of the virulence mechanisms of Ureaplasma spp. and treatment of ureaplasma infection during pregnancy to prevent possible serious sequelae in infants. In addition, relevant mechanisms underlying antibiotic resistance in Ureaplasma spp. are discussed. Ureaplasma spp. are naturally resistant against β-lactam antibiotics because of the lack of a cell wall. Azithromycin is one of the effective agents that can control intrauterine ureaplasma infection. In fact, macrolide-and fluoroquinolone-resistant isolates of Ureaplasma spp. have already been observed in perinatal practice in Japan.

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“…Studies in Australian women have suggested that genotype SV6 is significantly associated with PTB . A recent study in Austrian women reported that SV1, 3 and 6 were linked to preterm birth, although only SV3 was significantly associated with early PTB (<32 weeks gestation) . These discrepancies potentially indicate a geographical/ethnicity effect.…”

Section: Pathways To Uterine and Intra‐amniotic Infectionmentioning

confidence: 98%

Infection‐mediated preterm birth: Bacterial origins and avenues for intervention

Stinson

Payne

2019

Aust NZ J Obst Gynaeco

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Preterm birth (PTB, defined as birth before 37 weeks of gestation) is a major cause of neonatal morbidity and mortality. Globally, 15 million infants are born early each year. 1 Preterm infants are vulnerable to serious complications including respiratory distress syndrome, cerebral palsy, necrotising enterocolitis (NEC), longterm learning disabilities, intraventricular haemorrhage, sepsis, patent ductus arteriosus, retinopathy of prematurity, and chronic lung disease. The seriousness and prevalence of PTB-associated morbidity and mortality are inversely correlated with gestational age at delivery, with very early preterm infants bearing the majority of the burden. Further, the burden of prematurity is not purely medical -there is a significant economic and societal cost associated with PTB. 2 While there are many potential pathways to PTB, the focus of this review will be bacterial infection of the pregnant uterus and intra-amniotic space. Infection-mediated preterm birth has received substantial scientific attention, being the only PTB aetiology for which a direct causal link has been established. The bacterial causes of PTB have been extensively studied using culture-based and culture-independent techniques. However, despite decades of research, the success of preventative strategies has been very limited. Here, we will outline the pathogenesis of infection-mediated PTB, discuss routes of infection, and evaluate current and potential treatment options.Preterm birth (PTB) is globally the leading cause of death and disability in children under five years of age. Intra-amniotic infection is well recognised as a major cause of PTB. Importantly, it is the most common cause of extreme PTB (birth prior to 28 weeks gestation), which is frequently associated with a wide range of serious neonatal morbidities. Recent developments in next generation sequencing technologies, combined with many years of culture-based microbiological data have allowed us to gain a deeper understanding of the pathogenesis of infection-mediated PTB. In particular, studies have revealed numerous potential routes to intra-amniotic infection beyond the classically described ascending vaginal route. Currently, antibiotic therapy is standard treatment for suspected or confirmed intra-amniotic infection, although its use in this context has had mixed success due to problems ranging from inappropriate antibiotic selection in relation to the target organism/s, to poor transplacental drug passage. In this review, we will draw together evidence from animal models and human studies to characterise pathways to intra-amniotic infection. We will then thoroughly outline current therapeutic protocols for cases of intra-amniotic infection and suggest potential new avenues for treatment. K E Y W O R D Santibiotics, anti-inflammatory drugs, bacteriophage, intra-amniotic infection, preterm birth

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First Trimester Vaginal <b><i>Ureaplasma</i></b> Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

Cited by 29 publications

References 22 publications

Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice

Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice

Current understanding and treatment of intra‐amniotic infection with Ureaplasma spp.

Infection‐mediated preterm birth: Bacterial origins and avenues for intervention

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