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A controlled study of genital mycoplasmas in amniotic fluid from patients with intra-amniotic infection
Abstract:
Amniotic fluid (AF) was collected via a transcervical, intrauterine catheter from 52 patients with clinical intra-amniotic infection (IAI) and from 52 matched, uninfected controls. The AF was cultured for Mycoplasma hominis and Ureaplasma urealyticum as well as for aerobic and anaerobic bacteria. Eighteen (35%) patients with IAI and four (8%) controls had M. hominis in AF (P less than 0.001). Twenty-six (50%) patients with IAI and 26 (50%) control patients had U. urealyticum in AF (difference not significant). In the AF specimens of patients with IAI, 15 (83%) of the 18 with M. hominis also contained greater than or equal to 10(2) colony-forming units (cfu) of a high-virulence bacterial isolate/ml (P less than 0.05). Within the limitations of the experimental design, U. urealyticum in AF is not associated with clinical IAI, whereas, with qualitative cultures, M. hominis in AF is. However, in IAI, M. hominis is isolated most commonly from the AF of patients with greater than or equal to 10(2) cfu of a high-virulence bacterial isolate/ml.
Insights
Mycoplasma hominis in amniotic fluid (AF) is linked to intra-amniotic infection (IAI), unlike Ureaplasma urealyticum. High-virulence bacteria often co-occur with M. hominis in IAI cases.
Area of Science:
- Microbiology
- Obstetrics
- Infectious Diseases
Background:
- Intra-amniotic infection (IAI) is a significant complication in pregnancy.
- The role of specific microorganisms like Mycoplasma hominis and Ureaplasma urealyticum in IAI requires further clarification.
Purpose of the Study:
- To investigate the association between M. hominis and U. urealyticum in amniotic fluid (AF) and clinical intra-amniotic infection (IAI).
Main Methods:
- Amniotic fluid samples were collected from 52 patients with IAI and 52 matched controls.
- AF was cultured for M. hominis, U. urealyticum, and other aerobic/anaerobic bacteria.
- Quantitative bacterial cultures were performed, focusing on colony-forming units (cfu/ml).
Main Results:
- M. hominis was detected in 35% of IAI patients versus 8% of controls (P < 0.001).
- U. urealyticum showed no significant difference in detection rates between IAI patients (50%) and controls (50%).
- In IAI cases with M. hominis, 83% also had high-virulence bacteria (≥10(2) cfu/ml).
Conclusions:
- U. urealyticum in AF is not associated with clinical IAI.
- M. hominis in AF is associated with IAI, particularly when high-virulence bacteria are present.
- M. hominis detection in AF may serve as a marker for IAI, especially in conjunction with other bacterial pathogens.
