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Jung E, Romero R, Yoon BH, et al. Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination. J Perinat Med. 2021;49(9):1103-1121doi: 10.1515/jpm-2021-0191.
Jung, E., Romero, R., Yoon, B. H., Theis, K. R., Gudicha, D. W., Tarca, A. L., Diaz-Primera, R., Winters, A. D., Gomez-Lopez, N., Yeo, L., & Hsu, C. D. (2021). Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination. Journal of perinatal medicine, 49(9), 1103-1121. https://doi.org/10.1515/jpm-2021-0191
Jung, Eunjung, et al. "Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination." Journal of perinatal medicine vol. 49,9 (2021): 1103-1121. doi: https://doi.org/10.1515/jpm-2021-0191
Jung E, Romero R, Yoon BH, Theis KR, Gudicha DW, Tarca AL, Diaz-Primera R, Winters AD, Gomez-Lopez N, Yeo L, Hsu CD. Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination. J Perinat Med. 2021 Jul 07;49(9):1103-1121. doi: 10.1515/jpm-2021-0191. Print 2021 Nov 25. PMID: 34229367; PMCID: PMC8570988.
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J Perinat Med. 2021 Jul 07;49(9):1103-1121. doi: 10.1515/jpm-2021-0191. Print 2021 Nov 25.

Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination.

Journal of perinatal medicine

Eunjung Jung, Roberto Romero, Bo Hyun Yoon, Kevin R Theis, Dereje W Gudicha, Adi L Tarca, Ramiro Diaz-Primera, Andrew D Winters, Nardhy Gomez-Lopez, Lami Yeo, Chaur-Dong Hsu

Affiliations

  1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.
  2. Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
  3. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
  4. Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
  5. Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
  6. Detroit Medical Center, Detroit, MI, USA.
  7. Department of Obstetrics and Gynecology, Florida International University, Miami, FL, USA.
  8. BioMedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
  9. Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI, USA.
  10. Department of Computer Science, College of Engineering, Wayne State University, Detroit, MI, USA.
  11. Department of Physiology, Wayne State University School of Medicine, Detroit, MI, USA.

PMID: 34229367 PMCID: PMC8570988 DOI: 10.1515/jpm-2021-0191

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.

© 2021 Walter de Gruyter GmbH, Berlin/Boston.

Keywords: Acinetobacter ; Propionibacterium acnes ; acute funisitis; acute histologic chorioamnionitis; amniocentesis; interleukin-6; intra-amniotic infection; intra-amniotic inflammation; microbial burden; preterm labor with intact membranes

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