1. Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Author
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Kevin R. Theis, Roberto Romero, Adi L. Tarca, Eun Jung Jung, Dereje W. Gudicha, Bo Hyun Yoon, Andrew D. Winters, Nardhy Gomez-Lopez, Chaur-Dong Hsu, Lami Yeo, and Ramiro Diaz-Primera
- Subjects
Adult ,0301 basic medicine ,Amniotic fluid ,Microorganism ,Inflammation ,Article ,Microbiology ,03 medical and health sciences ,Propionibacterium acnes ,0302 clinical medicine ,Pregnancy ,Humans ,Medicine ,Clinical significance ,Pregnancy Complications, Infectious ,Correlation of Data ,030219 obstetrics & reproductive medicine ,Bacteria ,biology ,medicine.diagnostic_test ,Interleukin-6 ,business.industry ,Obstetrics and Gynecology ,Acinetobacter ,Amniotic Fluid ,biology.organism_classification ,Chorioamnionitis ,Cross-Sectional Studies ,030104 developmental biology ,Pediatrics, Perinatology and Child Health ,Amniocentesis ,Equipment Contamination ,Premature Birth ,Female ,medicine.symptom ,business - Abstract
Objectives Intra-amniotic infection, defined by the presence of microorganisms in the amniotic cavity, is often accompanied by intra-amniotic inflammation. Occasionally, laboratories report the growth of bacteria or the presence of microbial nucleic acids in amniotic fluid in the absence of intra-amniotic inflammation. This study was conducted to determine the clinical significance of the presence of bacteria in amniotic fluid samples in the absence of intra-amniotic inflammation. Methods A retrospective cross-sectional study included 360 patients with preterm labor and intact membranes who underwent transabdominal amniocentesis for evaluation of the microbial state of the amniotic cavity as well as intra-amniotic inflammation. Cultivation techniques were used to isolate microorganisms, and broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS) was utilized to detect the nucleic acids of bacteria, viruses, and fungi. Results Patients whose amniotic fluid samples evinced microorganisms but did not indicate inflammation had a similar perinatal outcome to those without microorganisms or inflammation [amniocentesis-to-delivery interval (p=0.31), spontaneous preterm birth before 34 weeks (p=0.83), acute placental inflammatory lesions (p=1), and composite neonatal morbidity (p=0.8)]. Conclusions The isolation of microorganisms from a sample of amniotic fluid in the absence of intra-amniotic inflammation is indicative of a benign condition, which most likely represents contamination of the specimen during the collection procedure or laboratory processing rather than early colonization or infection.
- Published
- 2021
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