Research Article
Year 2021,
Volume: 60 Issue: 1, 83 - 89, 31.03.2021
Abstract
Aim: The purpose of this prospective cohort study is to evaluate the possible microbiome of the amniotic cavity in the second trimester in asymptomatic pregnant women by the culture-based technique. Materials and Methods: This prospective cohort study was conducted in Gaziantep University Gynecology and Obstetrics Clinic between October 2017 and November 2019. 100 pregnant women who had amniocentesis for genetic screening in the fetus, and who had no complaints or clinical symptoms of vaginal or chorioamnionitis infection, were included in the study. While culture tests were performed by using the amniotic fluids of these pregnant women, glucose and leukocyte levels of their amniotic fluids were also measured. At the same time, culture and gram staining analyses were performed by collecting vaginal swab specimens from the patients. Results: 12 patients (12%, 95% confidence interval, 0 to 41%) had positive amniotic fluid culture results. The most observed bacteria were E. coli (5%). No findings of clinical infection were observed in the patients with positive amniotic fluid culture results. These patients delivered healthy babies with no complications. Conclusion: The amniotic fluid has its own microbiome, and the vaginal flora plays a role in the formation of this microbiome. This is a preliminary study; therefore, larger studies and targeted broad range molecular methods are needed to find the variety of the possible flora of the amniotic fluid.
References
- Romero R, Espinoza J, Chaiworapongsa T, Kalache K. Infection and prematurity and the role of preventive strategies. Semin Neonatol 2002; 7 (4): 259-74.
- Harris JW, Brown JH. The bacterial content of the uterus at cesarean section. AJOG 1927; 13 (2): 133-43.
- DiGiulio DB. Diversity of microbes in amniotic fluid. Semin Fetal Neonat M 2012;17 (1): 2-11.
- Zhou X, Brotman RM, Gajer P, et al. Recent advances in understanding the microbiology of the female reproductive tract and the causes of premature birth. Infect Dis Obstet Gynecol. 2010.
- Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. The placenta harbors a unique microbiome. Sci Transl Med 2014; 6 (237): 237ra65-237ra65.
- Antony KM, Ma J, Mitchell KB, Racusin DA, Versalovic J, Aagaard K. The preterm placental microbiome varies in association with excess maternal gestational weight gain. AJOG 2015; 212 (5): 653. e1-653. e16.
- Chu D, Stewart C, Seferovic M, et al. 26: Profiling of microbiota in second trimester amniotic fluid reveals a distinctive community present in the mid trimester and predictive of the placental microbiome at parturition. AJOG 2017; 216 (1): S18-S19.
- Gisslen T, Harris RA, Sweeney EL, et al. The placental microbiome is altered among subjects with spontaneous preterm birth with and without chorioamnionitis.2016.
- Pelzer E, Gomez-Arango LF, Barrett HL, Nitert MD. Maternal health and the placental microbiome. Placenta 2017; 54: 30-7.
- Lim ES, Rodriguez C, Holtz LR. Amniotic fluid from healthy term pregnancies does not harbor a detectable microbial community. Microbiome 2018; 6 (1): 1-8.
- Montuclard B, Guibert M, Ville Y, Frydman R, Fernandez H. Does asymptomatic amniotic infection in the second trimester really exist? J Gynecol Obstet Biol Reprod 1996; 25 (2): 186-91.
- Mändar R, Loivukene K, Ehrenberg A, et al. Amniotic fluid microflora in asymptomatic women at mid-gestation. Scand J Infect Dis 2001; 33 (1): 60-2.
- DiGiulio DB, Romero R, Amogan HP, et al. Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation. PloS one 2008; 3 (8): e3056.
- Gervasi MT, Romero R, Bracalente G, et al. Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and Volume 60 Issue 1, March 2021 / Cilt 60 Sayı 1, Mart 2021 89 associations with spontaneous early (< 32 weeks) and late (> 32 weeks) preterm delivery. J Perinat Med 2012; 40 (4): 329-43.
- Gerber S, Vial Y, Hohfeld P, Witkin SS. Detection of Ureaplasma urealyticum in second-trimester amniotic fluid by polymerase chain reaction correlates with subsequent preterm labor and delivery. J Infect Dis 2003; 187 (3): 518-21.
- Nguyen DP, Gerber S, Hohlfeld P, Sandrine G, Witkin SS. Mycoplasma hominis in mid-trimester amniotic fluid: relation to pregnancy outcome. J Perinat Med 2004; 32 (4): 323-6.
- Rowlands S, Danielewski JA, Tabrizi SN, Walker SP, Garland SM. Microbial invasion of the amniotic cavity in midtrimester pregnancies using molecular microbiology. AJOG 2017; 217 (1): 71. e1-71. e5.
- DiGiulio DB, Gervasi M, Romero R, et al. Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods. J Perinat Med 2010; 38 (5): 503-13.
- DiGiulio DB, Gervasi MT, Romero R, et al. Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses. J Perinat Med 2010; 38 (5): 495-502.
- DiGiulio DB, Romero R, Kusanovic JP, et al. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre‐labor rupture of membranes. Am J Reprod Immunol 2010; 64 (1):38-57.
- Collado MC, Rautava S, Aakko J, Isolauri E, Salminen S. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep 2016;6:23129.
- Willyard C. Could baby's first bacteria take root before birth? Nature 2018;553:7688.
- Perez-Muñoz ME, Arrieta MC, Ramer-Tait AE, Walter J. A critical assessment of the “sterile womb” and “in utero colonization” hypotheses: implications for research on the pioneer infant microbiome. Microbiome 2017; 5 (1): 48.
- Stout MJ, Conlon B, Landeau M, et al. Identification of intracellular bacteria in the basal plate of the human placenta in term and preterm gestations. AJOG 2013; 208 (3): 226. e1-226. e7.
- Jiménez E, Fernandez L, Marin ML, et al. Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by cesarean section. Curr Microbiol 2005; 51 (4): 270-4.
- Lauder AP, Roche AM, Sherrill-Mix S, et al. Comparison of placenta samples with contamination controls does not provide evidence for a distinct placenta microbiota. Microbiome 2016; 4 (1): 29.
- Combs CA, Gravett M, Garite TJ, et al. Amniotic fluid infection, inflammation, and colonization in preterm labor with intact membranes. AJOG 2014; 210 (2): 125. e1-125. e15.
- Mendz GL, Kaakoush NO, Quinlivan JA. Bacterial aetiological agents of intra-amniotic infections and preterm birth in pregnant women. Front Cell Infect Microbiol 2013;3:58.
- Stinson LF, Payne MS. Infection‐mediated preterm birth: Bacterial origins and avenues for intervention.Aust N Z J Obstet Gynaecol 2019; 59 (6): 781-90.
- Suff N, Karda R, Diaz JA, et al. Ascending vaginal infection using bioluminescent bacteria evokes intrauterine inflammation, preterm birth, and neonatal brain injury in pregnant mice. Am J Pathol 2018; 188 (10): 2164-76.
- Rehbinder EM, Carlsen KCL, Staff AC, et al. Is amniotic fluid of women with uncomplicated term pregnancies free of bacteria? AJOG 2018; 219 (3): 289. e1-289. e12.
- Kuperman AA, Zimmerman A, Hamadia S, et al. Deep microbial analysis of multiple placentas shows no evidence for a placental microbiome. BJOG 2020; 127 (2): 159-69.
Year 2021,
Volume: 60 Issue: 1, 83 - 89, 31.03.2021
Abstract
Amaç: Bu prospektif kohort çalışmasının amacı, ikinci trimesterde asemptomatik gebelerde amniyotik kavitenin olası mikrobiyomunu kültür temelli teknikle değerlendirmektir.
Gereç ve Yöntem: Bu prospektif kohort çalışma, Gaziantep Üniversitesi Kadın Hastalıkları ve Doğum Kliniği'nde Ekim 2017- Kasım 2019 tarihleri arasında gerçekleştirildi. Fetüste genetik tarama için amniyosentez yapılan, vajinal enfeksiyon veya koryoamniyonite dair klinik semptomu olmayan 100 gebe kadın çalışmaya dahil edildi. Bu gebelerin amniyotik sıvıları kullanılarak kültür testleri yapılırken, amniyotik sıvılarının glikoz ve lökosit düzeyleri de ölçüldü. Aynı zamanda hastalardan vajinal sürüntü örnekleri alınarak kültür ve gram boyama analizleri yapıldı.
Bulgular: 12 hastada (%12, %95 güven aralığı, %0 ile %41) amniyotik sıvı kültürü pozitif çıktı. En sık görülen bakteri E. coli idi (%5). Amniyotik sıvı kültürü sonucu pozitif olan hastalarda klinik enfeksiyon bulgusu izlenmedi. Bu hastalar hiçbir komplikasyon olmaksızın sağlıklı bebekler doğurdu.
Sonuç: Amniyotik sıvının kendi mikrobiyomu vardır ve vajinal flora bu mikrobiyomun oluşumunda rol oynar. Bu bir ön çalışmadır; bu nedenle, amniyotik sıvının olası florasının çeşitliliğini bulmak için daha büyük çalışmalara ve geniş kapsamlı moleküler yöntemlere ihtiyaç vardır.
Keywords
References
- Romero R, Espinoza J, Chaiworapongsa T, Kalache K. Infection and prematurity and the role of preventive strategies. Semin Neonatol 2002; 7 (4): 259-74.
- Harris JW, Brown JH. The bacterial content of the uterus at cesarean section. AJOG 1927; 13 (2): 133-43.
- DiGiulio DB. Diversity of microbes in amniotic fluid. Semin Fetal Neonat M 2012;17 (1): 2-11.
- Zhou X, Brotman RM, Gajer P, et al. Recent advances in understanding the microbiology of the female reproductive tract and the causes of premature birth. Infect Dis Obstet Gynecol. 2010.
- Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. The placenta harbors a unique microbiome. Sci Transl Med 2014; 6 (237): 237ra65-237ra65.
- Antony KM, Ma J, Mitchell KB, Racusin DA, Versalovic J, Aagaard K. The preterm placental microbiome varies in association with excess maternal gestational weight gain. AJOG 2015; 212 (5): 653. e1-653. e16.
- Chu D, Stewart C, Seferovic M, et al. 26: Profiling of microbiota in second trimester amniotic fluid reveals a distinctive community present in the mid trimester and predictive of the placental microbiome at parturition. AJOG 2017; 216 (1): S18-S19.
- Gisslen T, Harris RA, Sweeney EL, et al. The placental microbiome is altered among subjects with spontaneous preterm birth with and without chorioamnionitis.2016.
- Pelzer E, Gomez-Arango LF, Barrett HL, Nitert MD. Maternal health and the placental microbiome. Placenta 2017; 54: 30-7.
- Lim ES, Rodriguez C, Holtz LR. Amniotic fluid from healthy term pregnancies does not harbor a detectable microbial community. Microbiome 2018; 6 (1): 1-8.
- Montuclard B, Guibert M, Ville Y, Frydman R, Fernandez H. Does asymptomatic amniotic infection in the second trimester really exist? J Gynecol Obstet Biol Reprod 1996; 25 (2): 186-91.
- Mändar R, Loivukene K, Ehrenberg A, et al. Amniotic fluid microflora in asymptomatic women at mid-gestation. Scand J Infect Dis 2001; 33 (1): 60-2.
- DiGiulio DB, Romero R, Amogan HP, et al. Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation. PloS one 2008; 3 (8): e3056.
- Gervasi MT, Romero R, Bracalente G, et al. Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and Volume 60 Issue 1, March 2021 / Cilt 60 Sayı 1, Mart 2021 89 associations with spontaneous early (< 32 weeks) and late (> 32 weeks) preterm delivery. J Perinat Med 2012; 40 (4): 329-43.
- Gerber S, Vial Y, Hohfeld P, Witkin SS. Detection of Ureaplasma urealyticum in second-trimester amniotic fluid by polymerase chain reaction correlates with subsequent preterm labor and delivery. J Infect Dis 2003; 187 (3): 518-21.
- Nguyen DP, Gerber S, Hohlfeld P, Sandrine G, Witkin SS. Mycoplasma hominis in mid-trimester amniotic fluid: relation to pregnancy outcome. J Perinat Med 2004; 32 (4): 323-6.
- Rowlands S, Danielewski JA, Tabrizi SN, Walker SP, Garland SM. Microbial invasion of the amniotic cavity in midtrimester pregnancies using molecular microbiology. AJOG 2017; 217 (1): 71. e1-71. e5.
- DiGiulio DB, Gervasi M, Romero R, et al. Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods. J Perinat Med 2010; 38 (5): 503-13.
- DiGiulio DB, Gervasi MT, Romero R, et al. Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses. J Perinat Med 2010; 38 (5): 495-502.
- DiGiulio DB, Romero R, Kusanovic JP, et al. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre‐labor rupture of membranes. Am J Reprod Immunol 2010; 64 (1):38-57.
- Collado MC, Rautava S, Aakko J, Isolauri E, Salminen S. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep 2016;6:23129.
- Willyard C. Could baby's first bacteria take root before birth? Nature 2018;553:7688.
- Perez-Muñoz ME, Arrieta MC, Ramer-Tait AE, Walter J. A critical assessment of the “sterile womb” and “in utero colonization” hypotheses: implications for research on the pioneer infant microbiome. Microbiome 2017; 5 (1): 48.
- Stout MJ, Conlon B, Landeau M, et al. Identification of intracellular bacteria in the basal plate of the human placenta in term and preterm gestations. AJOG 2013; 208 (3): 226. e1-226. e7.
- Jiménez E, Fernandez L, Marin ML, et al. Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by cesarean section. Curr Microbiol 2005; 51 (4): 270-4.
- Lauder AP, Roche AM, Sherrill-Mix S, et al. Comparison of placenta samples with contamination controls does not provide evidence for a distinct placenta microbiota. Microbiome 2016; 4 (1): 29.
- Combs CA, Gravett M, Garite TJ, et al. Amniotic fluid infection, inflammation, and colonization in preterm labor with intact membranes. AJOG 2014; 210 (2): 125. e1-125. e15.
- Mendz GL, Kaakoush NO, Quinlivan JA. Bacterial aetiological agents of intra-amniotic infections and preterm birth in pregnant women. Front Cell Infect Microbiol 2013;3:58.
- Stinson LF, Payne MS. Infection‐mediated preterm birth: Bacterial origins and avenues for intervention.Aust N Z J Obstet Gynaecol 2019; 59 (6): 781-90.
- Suff N, Karda R, Diaz JA, et al. Ascending vaginal infection using bioluminescent bacteria evokes intrauterine inflammation, preterm birth, and neonatal brain injury in pregnant mice. Am J Pathol 2018; 188 (10): 2164-76.
- Rehbinder EM, Carlsen KCL, Staff AC, et al. Is amniotic fluid of women with uncomplicated term pregnancies free of bacteria? AJOG 2018; 219 (3): 289. e1-289. e12.
- Kuperman AA, Zimmerman A, Hamadia S, et al. Deep microbial analysis of multiple placentas shows no evidence for a placental microbiome. BJOG 2020; 127 (2): 159-69.
There are 32 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 31, 2021 |
| Submission Date | November 24, 2020 |
| Published in Issue | Year 2021Volume: 60 Issue: 1 |
