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Microbiological diagnostics of inneriotrobic infections
Elena Vitalevna Naumkina1,2, L V Kuklina1, E N Kravchenko1
1Federal State Budgetary Educational Institution of Higher Education «Omsk State Medical University».
Abstract:
Intrauterine infections - infectious diseases in which infection of the fetus occurred in the ante- or intrapartum period, accompanied by clinical manifestations. The purpose of this study was to study the information content and diagnostic significance of the microbiological research method for the etiological diagnosis of intrauterine infections of a bacterial nature. A retrospective (2011-2014) and prospective (2015-2019) analysis of the results of microbiological studies of biomaterials from puerperas and their newborns was carried out in 63 cases of early neonatal mortality with established diagnoses of intrauterine infections. In the study of the separated cervical canal, placenta samples, and amniotic fluid, seeding of coagulase-negative staphylococci was most frequently observed, among which the species Staphylococcus epidermidis dominated, Staphylococcus hominis, Staphylococcus haemolyticus, Staphylococcus warneri also met. Frequent isolation of group B streptococci from the placenta and amniotic fluid was revealed in comparison with the material from the cervical canal.The information content of the microbiological study of materials from the puerpera and the newborn in terms of confirmation of the pathogen and the fact of its transmission from mother to fetus/newborn does not exceed 30%. Even with high contamination of the genital tract of the puerpera, placenta or amniotic fluid, examination of the materials from the newborn immediately after birth often does not allow to identify the causative agent, probably due to the low degree of contamination at the initial stage of development of the infectious process. An increase in the diagnostic value of microbiological research can be facilitated by an increase in the frequency of examinations, the number of samples taken; the use of techniques to increase the sensitivity of cultural research at the stage of analysis; the use of molecular genetic methods, especially in the study of materials from newborns.
Insights
Microbiological testing for intrauterine infections has limited diagnostic value, often below 30%. Enhancing testing frequency, sample size, and using molecular methods can improve pathogen detection in newborns.
Area of Science:
- Medical Microbiology
- Neonatalogy
- Infectious Diseases
Background:
- Intrauterine infections pose significant risks to fetuses and newborns.
- Accurate etiological diagnosis is crucial for effective management and prevention.
Purpose of the Study:
- To evaluate the diagnostic significance of microbiological methods for bacterial intrauterine infections.
- To assess the information content of biomaterial analysis from mothers and newborns.
Main Methods:
- Retrospective and prospective analysis of microbiological studies (2011-2019).
- Examination of biomaterials (cervical canal, placenta, amniotic fluid) from 63 cases of early neonatal mortality.
- Identification of bacterial pathogens using culture methods.
Main Results:
- Coagulase-negative staphylococci (e.g., Staphylococcus epidermidis) were most frequently isolated.
- Group B streptococci were more common in placenta and amniotic fluid than cervical samples.
- Diagnostic yield of microbiological studies for pathogen confirmation and transmission did not exceed 30%.
Conclusions:
- Current microbiological methods have limited sensitivity for diagnosing intrauterine infections, especially in newborns immediately after birth.
- Increased examination frequency, sample size, and advanced techniques like molecular genetics are recommended to improve diagnostic accuracy.
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