Study of the vaginal and rectal microflora in pregnant women, with emphasis on Group B streptococci

摘要: In a first part of the PhD research we established degree correspondence between vaginal and rectal microflora. The composition human microflora is affected by several host factors, including, among others, age, menarche, hormonal changes, sexual activity, pregnancy use contraceptives or spermicides, as well individual habits such douching (405). Studies lactobacilli have demonstrated that Lactobacillus crispatus, L. jensenii, gasseri vaginalis are most commonly recovered species H2O2-producing (5, 172, 287, 380) absence from vagina has been associated with an increased risk for bacterial vaginosis (BV) (161, 241). BV condition whereby overgrown anaerobic bacteria, Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Mycoplasma Peptostreptococcus spp. Prevotella linked to shedding HIV in female genital tract (63), acquisition (161) herpes simplex virus type 2 (63, 161) preterm birth (174). Several known colonize both gastrointestinal reproductive tract, rectum may play important role source reservoir organisms (6, 238). question remains whether these endogeneous originate tract. To establish can serve possible colonisation econiche, cultured specimen pregnant women at 35-37 weeks gestation group B streptococci (GBS) screening program prevent GBS neonatal disease, identified isolates level tRNA intergenic length polymorphism analysis (tDNA-PCR) genotyped those subjects which same was isolated simultaneously vaginally rectally, RAPD-analysis (100). Also compared genotype (99). To further potential microflora, quantified loads six quantitative real-time PCR (qPCR), where were present niches (96). In summary, similarity niches, unexpectedly high, indicating indeed probably strong dynamic exchange exist. This confirmed finding five tested (except G. vaginalis), load correspondence. A second this regarded improving prepartum detection streptococci. Group cause sepsis meningitis, maternal infection. Early infection be prevented identifying high-risk pregnancies administering intrapartum antibiotics. Two different strategies, screening-based risk-based approach, used today order decrease incidence early-onset detect colonization women, CDC recommends isolation bacterium anorectal swab samples growth selective enrichment medium, Lim Broth (Todd–Hewitt broth supplemented antibiotics), followed subculture on sheep blood agar (57). However, procedure require 48 h complete its sensitivity might improved. We sampling culture techniques (98) found rectovaginal sensitive method Granada Chromagar techniques, only slightly improved enrichment. two targets (sip cfb genes), using (qPCR) approaches, i.e. hydrolysis probe (Taqman, Roche) hybridisation (Hybprobe, directly clinical sample after enrichment, previously optimized approach (97), (97). could molecular significantly higher than recommended also our approach. Rather surprisingly, direct application sample. consequences observation rapid combined DNA extraction/qPCR they now available screening, still unclear, will basis future rapidly evolving diagnostics.