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Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation
Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation
- Source :
- PLoS ONE, Vol 3, Iss 8, p e3056 (2008), PLoS ONE
- Publication Year :
- 2008
- Publisher :
- Public Library of Science (PLoS), 2008.
-
Abstract
- Background Preterm delivery causes substantial neonatal mortality and morbidity. Unrecognized intra-amniotic infections caused by cultivation-resistant microbes may play a role. Molecular methods can detect, characterize and quantify microbes independently of traditional culture techniques. However, molecular studies that define the diversity and abundance of microbes invading the amniotic cavity, and evaluate their clinical significance within a causal framework, are lacking. Methods and Findings In parallel with culture, we used broad-range end-point and real-time PCR assays to amplify, identify and quantify ribosomal DNA (rDNA) of bacteria, fungi and archaea from amniotic fluid of 166 women in preterm labor with intact membranes. We sequenced up to 24 rRNA clones per positive specimen and assigned taxonomic designations to approximately the species level. Microbial prevalence, diversity and abundance were correlated with host inflammation and with gestational and neonatal outcomes. Study subjects who delivered at term served as controls. The combined use of molecular and culture methods revealed a greater prevalence (15% of subjects) and diversity (18 taxa) of microbes in amniotic fluid than did culture alone (9.6% of subjects; 11 taxa). The taxa detected only by PCR included a related group of fastidious bacteria, comprised of Sneathia sanguinegens, Leptotrichia amnionii and an unassigned, uncultivated, and previously-uncharacterized bacterium; one or more members of this group were detected in 25% of positive specimens. A positive PCR was associated with histologic chorioamnionitis (adjusted odds ratio [OR] 20; 95% CI, 2.4 to 172), and funisitis (adjusted OR 18; 95% CI, 3.1 to 99). The positive predictive value of PCR for preterm delivery was 100 percent. A temporal association between a positive PCR and delivery was supported by a shortened amniocentesis-to-delivery interval (adjusted hazard ratio 4.6; 95% CI, 2.2 to 9.5). A dose-response association was demonstrated between bacterial rDNA abundance and gestational age at delivery (r2 = 0.42; P
- Subjects :
- Amniotic fluid
Time Factors
Public Health and Epidemiology/Infectious Diseases
lcsh:Medicine
Polymerase Chain Reaction
law.invention
Infectious Diseases/Bacterial Infections
Cohort Studies
Leukocyte Count
0302 clinical medicine
law
Pregnancy
Funisitis
lcsh:Science
Polymerase chain reaction
2. Zero hunger
0303 health sciences
030219 obstetrics & reproductive medicine
Multidisciplinary
Amnion
medicine.diagnostic_test
Pregnancy Outcome
Gestational age
3. Good health
medicine.anatomical_structure
Infectious Diseases
Amniocentesis
Female
Research Article
Obstetrics/Management of High-Risk Pregnancies
Fastidious organism
Infectious Diseases/Epidemiology and Control of Infectious Diseases
DNA, Bacterial
Gestational Age
Biology
Microbiology
DNA, Ribosomal
03 medical and health sciences
Obstetric Labor, Premature
medicine
Obstetrics/Preterm Labor
Humans
Ribosomal DNA
Molecular Biology
030304 developmental biology
Retrospective Studies
Interleukin-6
Patient Selection
lcsh:R
Microbiology/Medical Microbiology
medicine.disease
Amniotic Fluid
Immunology
lcsh:Q
Pediatrics and Child Health/Neonatology
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 3
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....490013127db4a040637aa1821cfd3ded