Neonatal leukemoid reaction associated with <i><scp>C</scp>andida albicans</i> chorioamnionitis

Iwatani, Sota; Mizobuchi, Masami; Sofue, Toshiki; Tanaka, Satoshi; Sakai, Hitomi; Yoshimoto, Seiji; Nakao, Hideto

doi:10.1111/ped.12259

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…In the current study, Candida albicans was detected in 5.1% (3/59) of patients with preterm PROM, and two of these three patients had acute histologic chorioamnionitis, which are consistent with our prior reports [61,226]. Fungal infections are important because they are well recognized pathogens implicated in fetal death and serious neonatal complications [227][228][229][230][231][232][233][234][235][236][237], and they require specific antimicrobial agents not generally used in the context of preterm PROM.…”

Section: Author Manuscriptsupporting

confidence: 90%

Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes

Romero

Miranda

Chaemsaithong

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

356

294

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Objective The objectives of this study were to: 1) determine the amniotic fluid (AF) microbiology of patients with preterm prelabor rupture of membranes (PROM); and 2) examine the relationship between intra-amniotic inflammation with and without microorganisms (sterile inflammation) and adverse pregnancy outcomes in patients with preterm PROM. Methods AF samples obtained from 59 women with preterm PROM were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital mycoplasmas) and with broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). AF concentration of interleukin-6 (IL-6) was determined using ELISA. Results of both tests were correlated with AF IL-6 concentrations, and the occurrence of adverse obstetrical/perinatal outcomes. Results 1) PCR/ESI-MS, AF culture, and the combination of these two tests, each identified microorganisms in 36% (21/59), 24% (14/59) and 41% (24/59) of women with preterm PROM, respectively; 2) the most frequent microorganisms found in the amniotic cavity were Sneathia species and Ureaplasma urealyticum; 3) the frequency of microbial-associated and sterile intra-amniotic inflammation was overall similar [ 29% (17/59)]: - however, the prevalence of each differed according to the gestational age when PROM occurred ; 4) the earlier the gestational age at preterm PROM, the higher the frequency of both microbial-associated and sterile intra-amniotic inflammation; 5) the intensity of the intra-amniotic inflammatory response against microorganisms is stronger when preterm PROM occurs early in pregnancy; and 6) the frequency of acute placental inflammation (histologic chorioamnionitis and/or funisitis) was significantly higher in patients with microbial-associated intra-amniotic inflammation than in those without intra-amniotic inflammation [93.3% (14/15) vs. 38% (6/16); p=0.001]. Conclusions 1) The frequency of microorganisms in preterm PROM is 40% using both cultivation and PCR/ESI-MS; 2) PCR/ESI-MS identified microorganisms in the AF of 50% more women with preterm PROM than did AF culture; and 3) sterile intra-amniotic inflammation was present in 29% of these patients, and it was as or more common than microbial-associated intra-amniotic inflammation among those presenting after, but not before, 24 weeks of gestation.

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Section: Author Manuscriptsupporting

confidence: 90%

Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes

Romero

Miranda

Chaemsaithong

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

356

294

View full text Add to dashboard Cite

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“…(1,62,120,(122)(123)(124). Other studies have identified that the sexually transmitted pathogens Chlamydia trachomatis and Neisseria gonorrhoeae, along with the uropathogen E. coli and yeast Candida spp., are also infrequently associated with chorioamnionitis (122,(125)(126)(127)(128). Viral etiologies of chorioamnionitis include adenovirus, cytomegalovirus, enterovirus, and, less frequently, respiratory syncytial virus and Epstein-Barr virus (129)(130)(131)(132).…”

Section: Causative Agents Of Chorioamnionitismentioning

confidence: 99%

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

et al. 2017

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SUMMARY The human Ureaplasma species are the most frequently isolated microorganisms from the amniotic fluid and placentae of women who deliver preterm and are also associated with spontaneous abortions or miscarriages, neonatal respiratory diseases, and chorioamnionitis. Despite the fact that these microorganisms have been habitually found within placentae of pregnancies with chorioamnionitis, the role of Ureaplasma species as a causative agent has not been satisfactorily explained. There is also controversy surrounding their role in disease, particularly as not all women infected with Ureaplasma spp. develop chorioamnionitis. In this review, we provide evidence that Ureaplasma spp. are associated with diseases of pregnancy and discuss recent findings which demonstrate that Ureaplasma spp. are associated with chorioamnionitis, regardless of gestational age at the time of delivery. Here, we also discuss the proposed major virulence factors of Ureaplasma spp., with a focus on the multiple-banded antigen (MBA), which may facilitate modulation/alteration of the host immune response and potentially explain why only subpopulations of infected women experience adverse pregnancy outcomes. The information presented within this review confirms that Ureaplasma spp. are not simply “innocent bystanders” in disease and highlights that these microorganisms are an often underestimated pathogen of pregnancy.

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“…Emerging evidence from recent studies supports an association between fungi (in particular yeasts such as Candida spp.) and chorioamnionitis 11 12 13 . Although Candida albicans ( C.albicans ) can be a commensal organism in the female genital tract, chorioamnionitis with C.albicans can cause fetal death or fetal candidiasis with systemic manifestations including sepsis 14 15 16 .…”

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confidence: 99%

Intra-amniotic Candida albicans infection induces mucosal injury and inflammation in the ovine fetal intestine

Nikiforou

Jacobs

Kemp

et al. 2016

Sci Rep

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Chorioamnionitis is caused by intrauterine infection with microorganisms including Candida albicans (C.albicans). Chorioamnionitis is associated with postnatal intestinal pathologies including necrotizing enterocolitis. The underlying mechanisms by which intra-amniotic C.albicans infection adversely affects the fetal gut remain unknown. Therefore, we assessed whether intra-amniotic C.albicans infection would cause intestinal inflammation and mucosal injury in an ovine model. Additionally, we tested whether treatment with the fungistatic fluconazole ameliorated the adverse intestinal outcome of intra-amniotic C.albicans infection. Pregnant sheep received intra-amniotic injections with 107 colony-forming units C.albicans or saline at 3 or 5 days before preterm delivery at 122 days of gestation. Fetuses were given intra-amniotic and intra-peritoneal fluconazole treatments 2 days after intra-amniotic administration of C.albicans. Intra-amniotic C.albicans caused intestinal colonization and invasive growth within the fetal gut with mucosal injury and intestinal inflammation, characterized by increased CD3+ lymphocytes, MPO+ cells and elevated TNF-α and IL-17 mRNA levels. Fluconazole treatment in utero decreased intestinal C.albicans colonization, mucosal injury but failed to attenuate intestinal inflammation. Intra-amniotic C.albicans caused intestinal infection, injury and inflammation. Fluconazole treatment decreased mucosal injury but failed to ameliorate C.albicans-mediated mucosal inflammation emphasizing the need to optimize the applied antifungal therapeutic strategy.

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Neonatal leukemoid reaction associated with Candida albicans chorioamnionitis

Cited by 7 publications

References 10 publications

Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes

Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

Intra-amniotic Candida albicans infection induces mucosal injury and inflammation in the ovine fetal intestine

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