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Characterization of Amniotic Fluid Ureaplasma Species from Pregnancies Complicated by Preterm Prelabor Rupture of
Antonin Libra1,2, Radka Bolehovska3,4, Rudolf Kukla3,4
1Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, 500 05, Czech Republic.
Abstract:
The main aim of this study was to determine expanded sequence types (eSTs) of Ureaplasma species (U. spp.). DNA isolated from the amniotic fluid of pregnancies complicated by preterm prelabor rupture of membranes (PPROM) using an expanded multilocus sequence typing scheme. Additionally, the study sought to examine whether phylogenetic subgroups of U. spp. DNA differ with respect to maternal demographic and clinical parameters and selected aspects of short-term neonatal morbidity. This retrospective cohort study was focused on singleton pregnancies complicated by PPROM occurring between the gestational ages of 24+0 and 36+6 weeks, where amniocentesis was conducted to assess the intra-amniotic environment and the presence of U. spp. DNA in the amniotic fluid samples was confirmed. The stored aliquots of U. spp. DNA were used to assess differences in nucleotide sequences in six U. spp. genes (ftsH, rpL22, valS, thrS,ureG, and mba-np1) using the eMLST scheme. The expanded multilocus sequence typing scheme was performed in 73 samples of U. spp. DNA isolated from pregnancies complicated by PPROM. In total, 33 different U. spp. DNA eSTs were revealed, 21 (#20, 233-244, 248-251, 253, 255, 259, and 262) of which were novel. The most frequently identified eST was #41, identified in 18% (13/73) of the aliquots. Based on their genetic relationships, the U. spp. DNA was divided into two clusters and four subgroups [cluster I (U. parvum): A, 43% (n = 31); B, 15% (n = 11); and C, 26% (n = 19); cluster II (U. urealyticum): 1; 16% (n = 12)]. Cluster II had a higher rate of polymicrobial findings than cluster I (58% vs 16%; p = 0.005), while subgroup A had the highest rate of concomitant Mycoplasma hominis in the amniotic fluid samples (66%; p = 0.04). In conclusion, Ureaplasma spp. DNA obtained from PPROM consisted of 33 different eSTs of U. spp. DNA. No differences in maternal and neonatal characteristics were found among the phylogenetical subgroups of U. spp. DNA, except for a higher rate of polymicrobial amniotic fluid findings in those with U. urealyticumand the concomitant presence of M. hominis in the amniotic fluid in those with the presence of U. parvum.
Insights
This study identified 33 expanded sequence types (eSTs) of Ureaplasma species DNA in preterm prelabor rupture of membranes (PPROM) pregnancies. No significant differences in maternal or neonatal characteristics were found among Ureaplasma phylogenetic subgroups.
Area of Science:
- Microbiology
- Genetics
- Obstetrics
Background:
- Ureaplasma species (U. spp.) are implicated in pregnancy complications.
- Preterm prelabor rupture of membranes (PPROM) is a significant obstetric concern.
- Understanding U. spp. genetic diversity is crucial for assessing its role in PPROM.
Purpose of the Study:
- To determine the expanded sequence types (eSTs) of Ureaplasma species DNA in amniotic fluid from PPROM pregnancies.
- To investigate associations between U. spp. phylogenetic subgroups and maternal/neonatal outcomes.
Main Methods:
- DNA was isolated from amniotic fluid of 73 singleton pregnancies with PPROM.
- Expanded multilocus sequence typing (eMLST) was performed on six U. spp. genes.
- Phylogenetic analysis was used to cluster U. spp. DNA based on genetic relatedness.
Main Results:
- 33 distinct U. spp. DNA eSTs were identified, including 21 novel types.
- U. spp. DNA clustered into two groups: U. parvum (clusters I A, B, C) and U. urealyticum (cluster II).
- Cluster II (U. urealyticum) showed a higher rate of polymicrobial findings (58%) compared to cluster I (16%). Subgroup A (U. parvum) had the highest rate of co-infection with Mycoplasma hominis (66%).
Conclusions:
- Ureaplasma species DNA in PPROM pregnancies exhibits significant genetic diversity with 33 identified eSTs.
- While no maternal or neonatal demographic differences were observed across subgroups, U. urealyticum was associated with increased polymicrobial presence, and U. parvum with M. hominis co-infection.
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