Polymicrobial Amniotic Fluid Infection with Mycoplasma/Ureaplasma and Other Bacteria Induces Severe Intra-Amniotic Inflammation Associated with Poor Perinatal Prognosis in Preterm Labor

Am J Reprod Immunol. 2016 Feb;75(2):112-25. doi: 10.1111/aji.12456. Epub 2015 Dec 15.

Abstract

Problem: To study the relationship between perinatal prognosis in cases of preterm labor (PTL) and polymicrobial infection in amniotic fluid (AF) and intra-amniotic (IA) inflammation using a highly sensitive and reliable PCR-based method.

Method of study: To detect prokaryotes using a nested PCR-based method, eukaryote-made thermostable DNA polymerase without bacterial DNA contamination was used in combination with bacterial universal primers. We collected AF aseptically from 118 PTL cases and 50 term subjects.

Results: The prevalence of microorganisms was 33% (39/118) by PCR and only 7.6% (9/118) by culture. PTL caused by a combination of positive Mycoplasma/Ureaplasma and other bacteria had significantly higher AF IL-8 levels and a significantly shorter amniocentesis-to-delivery interval.

Conclusions: Our newly established PCR method is useful for detecting IA microorganisms. Polymicrobial infection with Mycoplasma/Ureaplasma and other bacteria induces severe IA inflammation associated with poor perinatal prognosis in PTL.

Keywords: Eukaryote-made thermostable DNA polymerase; Ureaplasma spp; intra-amniotic infection; polymerase chain reaction; polymicrobial infection; preterm labor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amniotic Fluid / immunology
  • Amniotic Fluid / microbiology
  • Bacteria / genetics
  • Bacteria / isolation & purification
  • Bacterial Infections / immunology
  • Bacterial Infections / microbiology*
  • Chorioamnionitis / immunology
  • Chorioamnionitis / microbiology*
  • Coinfection / immunology
  • Coinfection / microbiology*
  • DNA, Bacterial / analysis
  • DNA, Fungal / analysis
  • Female
  • Fungi / genetics
  • Fungi / isolation & purification
  • Humans
  • Interleukin-8 / immunology
  • Leukocyte Count
  • Mycoses / immunology
  • Mycoses / microbiology*
  • Obstetric Labor, Premature / immunology
  • Obstetric Labor, Premature / microbiology*
  • Polymerase Chain Reaction / methods
  • Pregnancy
  • Prognosis
  • RNA, Ribosomal, 16S / genetics
  • Young Adult

Substances

  • DNA, Bacterial
  • DNA, Fungal
  • Interleukin-8
  • RNA, Ribosomal, 16S