Cervical bacterial colonization in women with preterm premature rupture of membrane and pregnancy outcomes: A cohort study

Saghafi, Nafiseh; Pourali, Leila; Ghazvini, Kiarash; Maleki, Asieh; Ghavidel, Mahdis; Babaki, Mohsen Karbalaeizadeh

doi:10.29252/ijrm.16.5.341

Cited by 17 publications

(17 citation statements)

References 23 publications

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“…The majority of E. coli strains were isolated from women with occasional infection, in relation to recurrent and chronic infection (Table 4). Persistent vaginal colonisation by E. coli is a significant risk factor for acute cystitis, recurrent urinary tract infections [24], and premature rupture of membranes, which lead to preterm labour [25]. The frequency of E. coli strains (95.2%) in the study sample was higher than that found in other countries [26,27].…”

Section: Discussionmentioning

confidence: 64%

“…While our strategy to group the strains was sound and systematic, the large diversity of the strains prevented an obvious clustering of biological or clinical characteristics. There are relatively few reports in the literature that characterize CVEC strains, and they report a variable level of heterogeneity, and a lack of association with clinical variables [5,25,26].…”

Section: Discussionmentioning

confidence: 99%

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Virulence gene transcription, phylogroups, and antibiotic resistance of cervico-vaginal pathogenic E. coli in Mexico

et al. 2020

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The pathogenicity of Escherichia coli strains that cause cervico-vaginal infections (CVI) is due to the presence of several virulence genes. The objective of this study was to define the variability regarding the genotype of antibiotic resistance, the transcription profiles of virulence genes after in vitro infection of the vaginal cell line A431 and the phylogroup composition of a group of cervico-vaginal E. coli strains (CVEC). A total of 200 E. coli strains isolated from Mexican women with CVI from two medical units of the Mexican Institute of Social Security were analysed. E. coli strains and antibiotic resistance genes were identified using conventional polymerase chain reaction (PCR), and phylogroups were identified using multiplex PCR. Virulence gene transcription was measured through reverse-transcriptase realtime PCR after infection of the vaginal cell line A431. The most common antibiotic resistance genes among the CVEC strains were aac(3)II, TEM, dfrA1, sul1, and qnrA. The predominant phylogroup was B2. The genes most frequently transcribed in these strains were fimH, papC, irp2, iroN, kpsMTII, cnf1, and ompT, mainly in CVEC strains isolated from chronic and occasional vaginal infections. The strains showed a large diversity of transcription of the virulence genes phenotype and antibiotic resistance genotype, especially in the strains of phylogroups, B2, A, and D. The strains formed 2 large clusters, which contained several subclusters. The genetic diversity of CVEC strains was high. These strains have a large number of transcription patterns of virulence genes, and one-third of them carry three to seven antibiotic resistance genes.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Virulence gene transcription, phylogroups, and antibiotic resistance of cervico-vaginal pathogenic E. coli in Mexico

et al. 2020

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“…PROM that occurs prior to 37 weeks of pregnancy is pre-premature rupture of fetal membranes (PPROM) and PROM that occurs after 37 weeks of pregnancy is term-premature rupture of fetal membranes (TPROM). The pathogenesis of TPROM is still unclear, but it usually results from vaginal flora, fallopian tube inflammation, insufficient trophoblastic infiltration, and the abnormal pressure of the amniotic cavity are possible causes of TPROM [4]. At present, clinical prediction of PROM is still difficult to achieve and the effect of traditional single conservative treatment strategies is not satisfactory.…”

Section: Introductionmentioning

confidence: 99%

A role for the NLRC4 inflammasome in premature rupture of membrane

Zhu¹,

Zhu

et al. 2020

PLoS ONE

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PROM is one of the common complications of perinatal period, which seriously threatens the mother and newborn. The purpose of this study was to identify the role of NLRC4 inflammasomes in this process and their underlying mechanisms. We performed high-throughput RNA sequencing of fetal membrane tissue from 3 normal pregnant women and 3 term-premature rupture of fetal membrane (TPROM) patients who met the inclusion criteria, and found that NLRC4 was significantly up-regulated in TPROM patients. An observational study of TPROM patients (PROM group, n = 30) and normal pregnant women (control group, n = 30) was performed at the Xuzhou Maternal and Child Health Hospital affiliated to Xuzhou Medical University from May 2018 to May 2019. The expression of genes involved in inflammasome complex including NLRC1, NLRC3, AIM2, NLRC4, ASC, caspase-1, IL-6, IL-18 and IL-1βwas determined via real-time PCR, immunohistochemistry and immunofluorescence. Measurement of NLRC4 level in serum was conducted by ELISA assay. The results showed that the NLRC4, ASC, caspase-1, IL-1β and IL-18 levels in fetal membrane, placental tissues and maternal serum were markedly higher in the PROM group than that in the control group. In conclusion, NLRC4 is a markedly up-regulated gene in TPROM fetal membrane tissue, suggesting that NLRC4 is involved in the occurrence and development of TPROM; NLRC4 levels in maternal blood serum are closely related to TPROM and have the potential to assist doctors in predicting and diagnosing PROM.

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“…A study in Europe documented a similar prevalence of E. coli of 14 % in cervical samples of women in PTL [ 32 ]. On the other hand, endocervical colonization rates were lower at 3.5 % among women in labor in Switzerland [ 33 ] and higher at 24 % in Iranian women with premature preterm rupture of membranes ROM [ 34 ]. Our pilot study provides initial information on the prevalence of E. coli cervical colonization in US women in PTL.…”

Section: Discussionmentioning

confidence: 99%

Whole-genome sequencing-based phylogeny, antibiotic resistance, and invasive phenotype of Escherichia coli strains colonizing the cervix of women in preterm labor

et al. 2021

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Background Escherichia coli is a major neonatal pathogen and the leading cause of early-onset sepsis in preterm newborns. Maternal E. coli strains are transmitted to the newborn causing invasive neonatal disease. However, there is a lack of data regarding the phenotypic and genotypic characterization of E. coli strains colonizing pregnant women during labor. Methods This prospective study performed at the University of Oklahoma Medical Center (OUHSC) from March 2014 to December 2015, aimed to investigate the colonization rate, and the phylogeny, antibiotic resistance traits, and invasive properties of E. coli strains colonizing the cervix of fifty pregnant women diagnosed with preterm labor (PTL). Molecular analyses including bacterial whole-genome sequencing (WGS), were performed to examine phylogenetic relationships among the colonizing strains and compare them with WGS data of representative invasive neonatal E. coli isolates. Phenotypic and genotypic antibiotic resistance traits were investigated. The bacteria’s ability to invade epithelial cells in vitro was determined. Results We recruited fifty women in PTL. Cervical samples yielded E. coli in 12 % (n=6). The mean gestational age was 32.5 (SD±3.19) weeks. None delivered an infant with E. coli disease. Phenotypic and genotypic antibiotic resistance testing did not overall demonstrate extensive drug resistance traits among the cervical E. coli isolates, however, one isolate was multi-drug resistant. The isolates belonged to five different phylogroups, and WGS analyses assigned each to individual multi-locus sequence types. Single nucleotide polymorphism-based comparisons of cervical E. coli strains with six representative neonatal E. coli bacteremia isolates demonstrated that only half of the cervical E. coli isolates were phylogenetically related to these neonatal invasive strains. Moreover, WGS comparisons showed that each cervical E. coli isolate had distinct genomic regions that were not shared with neonatal E. coli isolates. Cervical and neonatal E. coli isolates that were most closely related at the phylogenetic level had similar invasion capacity into intestinal epithelial cells. In contrast, phylogenetically dissimilar cervical E. coli strains were the least invasive among all isolates. Conclusions This pilot study showed that a minority of women in PTL were colonized in the cervix with E. coli, and colonizing strains were not phylogenetically uniformly representative of E. coli strains that commonly cause invasive disease in newborns. Larger studies are needed to determine the molecular characteristics of E. coli strains colonizing pregnant women associated with an increased risk of neonatal septicemia.

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Cervical bacterial colonization in women with preterm premature rupture of membrane and pregnancy outcomes: A cohort study

Cited by 17 publications

References 23 publications

Virulence gene transcription, phylogroups, and antibiotic resistance of cervico-vaginal pathogenic E. coli in Mexico

Virulence gene transcription, phylogroups, and antibiotic resistance of cervico-vaginal pathogenic E. coli in Mexico

A role for the NLRC4 inflammasome in premature rupture of membrane

Whole-genome sequencing-based phylogeny, antibiotic resistance, and invasive phenotype of Escherichia coli strains colonizing the cervix of women in preterm labor

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