Microbial Prevalence, Diversity and Abundance in Amniotic Fluid During Preterm Labor: A Molecular and Culture-Based Investigation

摘要: 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 quantify independently of traditional culture techniques. However, molecular studies that define the diversity abundance invading amniotic cavity, evaluate their clinical significance within causal framework, are lacking. Methods Findings In parallel with culture, we used broad-range end-point real-time PCR assays to amplify, identify ribosomal DNA (rDNA) bacteria, fungi archaea from fluid 166 women in preterm labor intact membranes. We sequenced up 24 rRNA clones per positive specimen assigned taxonomic designations approximately species level. Microbial prevalence, were correlated host inflammation gestational outcomes. Study subjects who delivered at term served as controls. The combined use revealed greater prevalence (15% subjects) (18 taxa) than did alone (9.6% subjects; 11 taxa). taxa detected only included related group fastidious comprised Sneathia sanguinegens, Leptotrichia amnionii an unassigned, uncultivated, previously-uncharacterized bacterium; one or more members this 25% specimens. A was associated histologic chorioamnionitis (adjusted odds ratio [OR] 20; 95% CI, 2.4 172), funisitis OR 18; 3.1 99). predictive value for 100 percent. temporal association between supported shortened amniocentesis-to-delivery interval hazard 4.6; 2.2 9.5). dose-response demonstrated bacterial rDNA age (r2 = 0.42; P<0.002). Conclusions The cavity harbors previously suspected, including as-yet taxa. strength, temporality gradient which these microbial sequence types support relationship.