Is Ureaplasma spp. the leading causative agent of acute chorioamnionitis in women with preterm birth?

Kikhney, Judith; Schöning, D. von; Steding, Ina; Schulze, Julia; Petrich, Annett; Hiergeist, Andreas; Reischl, Udo; Moter, Annette; Thomas, Anke

doi:10.1016/j.cmi.2016.10.010

Cited by 25 publications

(8 citation statements)

References 30 publications

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“…This finding had similarity from the data reported by the study conducted by Kikhney et al (2017). In Germany For 20 women in the preterm group, caesarean section was performed because of a clinical diagnosis of chorioamnionitis.…”

Section: The Most Dominant Isolated Microorganisms In Women With Preterm Birth and Term Birthsupporting

confidence: 87%

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Study of chorioamnionitis among women with preterm birth at Ruhengeri referral hospital

Yadufashije¹,

Umugwaneza²,

Izere³

et al. 2019

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Background: Chorioamnionitis is the association of microorganisms infection in fetal membrane, placental membrane and amniotic fluid. About 2 to 4% of chorioamnionitis occurs in full-term deliveries, but higher than this prevalence in preterm birth. Objectives: The objective of this study was to detect the most dominant bacteria of chorioamnionitis and evaluate correlation of the presence of microorganisms infection in placental membrane, fetal membrane and amniotic fluids in women with preterm birth. Methods: It was cross section study where 20 women with preterm premature rupture of membrane, premature rupture of membrane or preterm birth. By caesarean section or without caesarean section with a group of control of 10 women with term delivery. After delivery immediately the samples swab of amniotic fluid, fetal membrane and placenta membrane sample were placed in separate sterile container (swabs Stuart plastic) in the hospital, where it was stored at temperatures ranging between 8 o C-20 o C. Culture technique, gram staining and biochemical test were used to identify the microorganisms in this study at INES-Ruhengeri Microbiology laboratory. At the Ruhengeri Referral Hospital and analyzed according to INES Microbiology Laboratory standard operating procedures. Results: in 20 women with preterm birth, the most dominant mircoroganism was yeast 28.4% and mould 28.4%, other infections were caused by Escherichia coli, with 9.3%, Klebsiella species with 3.7%, Streptococcus species with 9.3%, Staphylococcus species with 9.3%, Candida albican with 11.7%. Those microorganisms show the association in fetal membrane, placenta membrane and amniotic fluid, of all women suspected to have chorioamnionitis. In 10 samples of control group, for women with term birth, same microorganisms were found like in fetal membrane were (Staphylococcus species 11%, mould 33%, and Yeast 56%), in placenta membrane were (Staphylococcus species 20%, mould 30%, Yeast 50%) and Amniotic fluid were (Staphylococcus species 0%, mould 33%, Yeast 67%). Conclusion: Chorioamnionitis can be in women with preterm birth or with term birth, untreated microorganism infections will cause a big problem of chorioamnionitis in pregnant women this will conduct to preterm morbidity and mortality.

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Section: The Most Dominant Isolated Microorganisms In Women With Preterm Birth and Term Birthsupporting

confidence: 87%

“…Among those, Ureaplasma spp. was most abundant, with five cases that remained culture negative and would have been missed by routine diagnostic procedures (Kikhney et al, 2017).…”

Section: The Most Dominant Isolated Microorganisms In Women With Preterm Birth and Term Birthmentioning

confidence: 99%

Study of chorioamnionitis among women with preterm birth at Ruhengeri referral hospital

Yadufashije¹,

Umugwaneza²,

Izere³

et al. 2019

afjbs

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“…parvum serovar 14 is detected in the reproductive tissues and induces a local inflammatory response. Similar to the fetus, microbes in the amniotic cavity can also invade the surrounding tissues such as the chorioamniotic membranes (also known as fetal membranes) and placenta (31,32). Thus, we proceeded to evaluate whether intra-amniotic U. parvum serovar 14 can be detected in the reproductive tissues surrounding the amniotic cavity as well as the maternal organs.…”

Section: Resultsmentioning

confidence: 99%

Intra-Amniotic Infection with Ureaplasma parvum Causes Preterm Birth and Neonatal Mortality That Are Prevented by Treatment with Clarithromycin

Motomura

Romero

et al. 2020

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Intra-amniotic infection is strongly associated with adverse pregnancy and neonatal outcomes. Most intra-amniotic infections are due to Ureaplasma species; however, the pathogenic potency of these genital mycoplasmas to induce preterm birth is still controversial. Here, we first laid out a taxonomic characterization of Ureaplasma isolates from women with intra-amniotic infection, which revealed that Ureaplasma parvum is the most common bacterium found in this clinical condition. Next, using animal models, we provided a causal link between intra-amniotic inoculation with Ureaplasma species and preterm birth. Importantly, the intra-amniotic inoculation of Ureaplasma species induced high rates of mortality in both preterm and term neonates. The in vivo potency of U. parvum to induce preterm birth was not associated with known virulence factors. However, term-derived and preterm-derived U. parvum isolates were capable of inducing an intra-amniotic inflammatory response. Both U. parvum isolates invaded several fetal tissues, primarily the fetal lung, and caused fetal inflammatory response syndrome. This bacterium was also detected in the placenta, reproductive tissues, and most severely in the fetal membranes, inducing a local inflammatory response that was replicated in an in vitro model. Importantly, treatment with clarithromycin, a recently recommended yet not widely utilized antibiotic, prevented the adverse pregnancy and neonatal outcomes induced by U. parvum. These findings shed light on the maternal-fetal immunobiology of intra-amniotic infection. IMPORTANCE Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. Multiple etiologies are associated with preterm birth; however, 25% of preterm infants are born to a mother with intra-amniotic infection, most commonly due to invasion of the amniotic cavity by Ureaplasma species. Much research has focused on establishing a link between Ureaplasma species and adverse pregnancy/neonatal outcomes; however, little is known about the taxonomy of and host response against Ureaplasma species. Here, we applied a multifaceted approach, including human samples, in vivo models, and in vitro manipulations, to study the maternal-fetal immunobiology of Ureaplasma infection during pregnancy. Furthermore, we investigated the use of clarithromycin as a treatment for this infection. Our research provides translational knowledge that bolsters scientific understanding of Ureaplasma species as a cause of adverse pregnancy/neonatal outcomes and gives strong evidence for the use of clarithromycin as the recommended treatment for women intra-amniotically infected with Ureaplasma species.

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“…[31, 32] and Chlamydia trachomatis infection [33], that are responsible of genitourinary infections, which are responsible of spontaneous preterm labour, prematurity with infant with low birth weight, stillbirth or neonatal death [34]. Additionally, preterm birth, neonatal sepsis and bacterial meningitis are also associated with maternal rectovaginal colonization by group B Streptococcus [35] and Escherichia coli [36, 37]. Although resistance of these pathogens to doxycycline or tetracycline has been observed in Africa (16.9% of 1041 Streptococcus pneumoniae isolates in Kenya, 54.5% in comparison to 86.7% for ampicillin for Escherichia coli ) [38, 39], doxycycline remains efficacious.…”

Section: Doxycycline Is Efficacious Against Pathogens That Are Responmentioning

confidence: 99%

Has doxycycline, in combination with anti-malarial drugs, a role to play in intermittent preventive treatment of Plasmodium falciparum malaria infection in pregnant women in Africa?

Gaillard¹,

Madamet²,

Pradines³

2018

Malar J

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According to the World Health Organization (WHO), Plasmodium falciparum malaria during pregnancy is responsible for deleterious consequences for the mother and her child. The administration of intermittent preventive treatment (IPTp) with sulfadoxine–pyrimethamine (SP) at each antenatal care visit as early as 13 weeks of gestation until the time of delivery is a strategy that is currently recommended by WHO for the prevention of malaria in pregnancy. However, the emergence and the spread of the resistance to SP in Africa raise the question of the short-term effectiveness of the strategy. Dihydroartemisinin–piperaquine 120 mg/960 mg once a day for 3 consecutive days administered at least three times during the pregnancy might be an option for IPTp. The combination of 200 mg of doxycycline once a day for 3 consecutive days seems to be a good option to retard the emergence and the spread of resistance to artemisinin-based combination therapy (ACT) in Africa and improve the effectiveness of ACT in term of preterm births, neonatal morbidity and mortality. Contrary to preconceived ideas, scientific and medical data suggest that the risk of congenital malformations in the fetus or of tooth staining in infants whose mothers take doxycycline and hepatotoxicity during pregnancy is very low or non-existent. Additionally, the use of doxycycline during the first and second trimesters leads to an increase in gestational age at delivery, a decrease in the number of preterm births and a reduction in neonatal morbidity and mortality due to the beneficial antimicrobial activity of doxycycline against other infections during pregnancy. Furthermore, doxycycline has anti-malarial properties and is already recommended as prophylaxis for travellers and for treatment of falciparum malaria in combination with other anti-malarial drugs.

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Is Ureaplasma spp. the leading causative agent of acute chorioamnionitis in women with preterm birth?

Abstract: Combination of FISH with broad-range PCR and sequencing permitted unambiguous identification of the causative microorganisms in chorioamnionitis. The high prevalence of Ureaplasma spp. should lead to a re-evaluation of its clinical significance and possible therapeutic consequences.

Cited by 25 publications

References 30 publications

Study of chorioamnionitis among women with preterm birth at Ruhengeri referral hospital

Study of chorioamnionitis among women with preterm birth at Ruhengeri referral hospital

Intra-Amniotic Infection with Ureaplasma parvum Causes Preterm Birth and Neonatal Mortality That Are Prevented by Treatment with Clarithromycin

Has doxycycline, in combination with anti-malarial drugs, a role to play in intermittent preventive treatment of Plasmodium falciparum malaria infection in pregnant women in Africa?

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