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The association between the absence of amniotic fluid bacterial inhibitory activity and intra-amniotic infection
Abstract:
We studied the relationship of amniotic fluid bacterial inhibition in 50 patients with intra-amniotic infection to that in 50 matched control patients. Amniotic fluid was collected through a transcervical intrauterine catheter. All infected patients had clinical signs of intra-amniotic infection and greater than or equal to 10 2 colony-forming units per milliliter of a high-virulence organism. None of the control patients became infected. The matching characteristics for the intra-amniotic infection group versus the control group were: interval from rupture of the membranes to delivery (14.30 +/- 7.96 versus 15.00 +/- 7.19 hours, NS), interval from rupture of the membranes to collection of amniotic fluid (12.41 +/- 6.37 versus 12.16 +/- 6.46 hours NS), and gestational age (40.3 +/- 1.6 versus 40.0 +/- 1.6 weeks, NS). All patients were in labor. We tested each sample of amniotic fluid for inhibitory activity to Escherichia coli by a plate-count technique. Thirty-five samples (70%) of intra-amniotic infection fluid were noninhibitory, whereas 16 samples (32%) of control fluid were noninhibitory. The conclusion was that amniotic fluid from patients with intra-amniotic infection was significantly less likely to be inhibitory to E. coli (p less than 0.001).
Insights
Amniotic fluid from patients with intra-amniotic infection shows reduced bacterial inhibition against Escherichia coli. This finding suggests a compromised defense mechanism in infected pregnancies, impacting maternal and fetal health.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Microbiology
Background:
- Intra-amniotic infection (IAI) is a serious complication during pregnancy.
- Bacterial inhibition in amniotic fluid is a key defense mechanism against infection.
Purpose of the Study:
- To investigate the bacterial inhibitory capacity of amniotic fluid in patients with IAI compared to healthy controls.
- To determine if IAI compromises the natural antimicrobial properties of amniotic fluid.
Main Methods:
- A case-control study involving 50 patients with IAI and 50 matched controls.
- Amniotic fluid samples collected via transcervical intrauterine catheter.
- Plate-count technique used to assess amniotic fluid's inhibitory activity against Escherichia coli.
Main Results:
- 70% of amniotic fluid samples from patients with IAI were noninhibitory to E. coli.
- Only 32% of control amniotic fluid samples were noninhibitory.
- Amniotic fluid from infected patients demonstrated significantly lower inhibitory activity (p < 0.001).
Conclusions:
- Amniotic fluid from patients with intra-amniotic infection has a significantly reduced ability to inhibit E. coli growth.
- This diminished inhibitory activity may contribute to the pathogenesis of intra-amniotic infections.
- Loss of amniotic fluid's protective antimicrobial properties is associated with intra-amniotic infection.