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Amniotic fluid (AF) was collected via a transcervical, intrauterine catheter from 52 patients with clinical intra-amniotic infection (IAI) and from 52 matched, uninfected controls. The AF was cultured for Mycoplasma hominis and Ureaplasma urealyticum as well as for aerobic and anaerobic bacteria. Eighteen (35%) patients with IAI and four (8%) controls had M. hominis in AF (P less than 0.001). Twenty-six (50%) patients with IAI and 26 (50%) control patients had U. urealyticum in AF (difference not significant). In the AF specimens of patients with IAI, 15 (83%) of the 18 with M. hominis also contained greater than or equal to 10(2) colony-forming units (cfu) of a high-virulence bacterial isolate/ml (P less than 0.05). Within the limitations of the experimental design, U. urealyticum in AF is not associated with clinical IAI, whereas, with qualitative cultures, M. hominis in AF is. However, in IAI, M. hominis is isolated most commonly from the AF of patients with greater than or equal to 10(2) cfu of a high-virulence bacterial isolate/ml.

Amniotic fluid was collected through an intrauterine catheter from 52 women with clinical intraamniotic infection and from 52 uninfected matched control women. The amniotic fluid was cultured quantitatively for anaerobes and aerobes. Patients with intraamniotic infection were matched with the control women on the basis of gestational age, interval from membrane rupture to specimen collection, and interval from membrane rupture to delivery. The patients with intraamniotic infection had a significantly higher mean temperature (38.4 vs. 37.1 C) and a higher mean leukocyte count (15,740 vs. 11,740 cells/mm3). In 80.6% of specimens from the women with intraamniotic infection and 30.8% of those from the control subjects, greater than or equal to 10(2) colony-forming units (cfu)/ml were isolated from the amniotic fluid (P less than 0.001). Also, in 69.2% of the former and 7.7% of the latter, there were greater than or equal to 10(2) cfu of isolates considered to be "high-virulence" isolates/ml (P less than 0.001).