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32-week premature rupture of membranes caused by oropharyngeal microbiota
Alberto Hidalgo-Chicharro1, Raquel Abad-Torreblanca2, José María Navarro-Marí3
1Unidad de Gestión Clínica de Obstetricia y Ginecología, Hospital Universitario San Cecilio, Granada, Spain.
Abstract:
Introduction. Preterm premature rupture of membranes (PPROM) usually has a multifactorial etiology that is often unknown, although the most frequently reported cause is infection by group B Streptococcus. Therefore, the etiology of PPROM, although probably infectious, remains unknown in most cases. This case describes a PPROM caused by infection from oropharyngeal microbiota. Case presentation. We report the case of a 26-yr-old pregnant woman. The gestational age was 32 weeks+5 days. Examinations in the emergency department revealed the release of clear amniotic fluid and a closed multiparous cervix with a length of 22 mm. Endocervical culture evidenced the growth of Staphylococcus aureus, serogroup B Neisseria meningitidis and Haemophilus influenzae. Conclusion. Preventive antibiotic therapy should consider: opportunistic infections by normal genital microbiota, infections due to sexual activity, opportunist microorganisms derived from oral sex, and the hematogenous spread of oral bacteria.
Insights
Preterm premature rupture of membranes (PPROM) can stem from unknown causes, but this case highlights oropharyngeal bacteria as a potential infectious etiology. Preventive antibiotics should consider oral bacteria and opportunistic infections.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Microbiology
Background:
- Preterm premature rupture of membranes (PPROM) is a significant obstetric complication with multifactorial causes, often unidentified.
- Infection, particularly by group B Streptococcus, is a frequently implicated factor, yet the precise etiology remains elusive in many PPROM cases.
Observation:
- A case of PPROM at 32 weeks+5 days gestation is presented.
- Endocervical cultures revealed the presence of Staphylococcus aureus, serogroup B Neisseria meningitidis, and Haemophilus influenzae.
Findings:
- This case suggests that oropharyngeal microbiota can cause PPROM.
- The identified microorganisms are typically found in the oral cavity and can potentially ascend to the reproductive tract.
Implications:
- Preventive antibiotic strategies for PPROM should broaden their scope.
- Consideration should be given to opportunistic genital infections, sexually transmitted pathogens, oral microorganisms from oral sex, and hematogenous spread of oral bacteria.
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