Volume 16, Issue 5 (May 2018)                   IJRM 2018, 16(5): 341-348 | Back to browse issues page


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Saghafi N, Pourali L, Ghazvini K, Maleki A, Ghavidel M, Karbalaeizadeh Babaki M. Cervical bacterial colonization in women with preterm premature rupture of membrane and pregnancy outcomes: A cohort study. IJRM 2018; 16 (5) :341-348
URL: http://ijrm.ir/article-1-1110-en.html
1- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Medical Bacteriology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran , pouralil@mums.ac.ir
3- Department of Medical Bacteriology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4- Department of Medical Bacteriology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract:   (3659 Views)
Background: One of the most important etiologies in pretermpremature rupture of membranes (PPROM) is cervical bacterial colonization.
Objective: This study evaluated cervical bacterial colonization in women with PPROM and the pregnancy outcomes.
Materials and Methods: In this cohort study, 200 pregnant women with PPROM at 27-37 wk of gestation who were admitted in an academic hospital of Mashhad University of Medical Sciences from March 2015 to July 2016 were studied. samples were obtained from endocervical canal for detection of routine bacteria and Gram staining. Also, we obtained one blood culture from neonates. Maternal endocervical culture, chorioamnionitis, neonatal intensive care unit admission, neonatal positive blood culture, neonatal sepsis, and mortality were documented.
Results: Most common isolated microorganism of endocervical culture were Escherichia coli (24.2%), Coagulase negative Staphylococci (27.2%), Enterococcus and candida each one (11.7%). The prevalence of GBS was only 2.2%. Simultaneous positive blood cultures were seen in 3% of neonates. Among them, Gram-negative bacilli accounted for (66.6%), while Gram-positive cocci and candida made up only (16.7%). Endocervical colonization was associated with a higher admission rate (p=0.004), but there was no significant correlation between endocervical colonization and chorioamnionitis, positive blood culture and neonatal mortality rate.
Conclusion: With regard to low GBS colonization rate, appropriate antibiotic regimens should be considered in PPROM cases according to the most prevalent micro organisms of endocervical bacterial colonization. Maybe cervical bacterial colonization had some effects on neonatal outcomes. There was no significant association between endocervical bacterial colonization and chorioamnionitis, positive neonatal blood culture and neonatal mortality.
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Type of Study: Original Article |

References
1. Cunningham FG, Leveno KJ, BlOOM SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 24th Ed. New York, McGraw-Hill; 2014: 829-854.
2. Getahun D, Ananth CV, Oyelese Y, Peltier MR, Smulian JC, Vintzileos AM. Acute and chronic respiratory diseases in pregnancy: associations with spontaneous premature rupture of membranes. J Matern Fetal Neonatal Med 2007; 20: 669-675. [DOI:10.1080/14767050701516063]
3. Goodnight W, Acharya K, Hastings A, Carter L, Marshall D. Influence of PPROM on abnormal neurodevelopmental testing in early childhood. Am J Obstet Gynecol 2012; 206 (Suppl.): S242. [DOI:10.1016/j.ajog.2011.10.553]
4. Verani JR, McGee L, Schrag SJ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59: 1-36.
5. Yudin MH, van Schalkwyk J, Eyk NV, Infectious diseases committee, Maternal fetal medicine committee. Antibiotic therapy in preterm premature rupture of the membranes. J Obstet Gynaecol Can 2009; 31: 863-867. [DOI:10.1016/S1701-2163(16)34305-5]
6. Goncalves LF, Chaiworapongsa T, Romero R. Intrauterine infection and prematurity. Ment Retard Dev Disabil Res Rev 2002; 8: 3-13. [DOI:10.1002/mrdd.10008]
7. Lajos GJ, Passini Junior R, Nomura ML, Amaral E, Pereira BG, Milanez H, et al. Cervical bacterial colonization in women with preterm labor or premature rupture of membranes. Rev Bras Ginecol Obstet 2008; 30: 393-399.
8. James D, Steer P, Weiner C, Gonik B. High risk pregnancy 4th Ed. Philadelphia, Saunders Elsevier; 2011: 1091-1100.
9. Saghafi N, Kadkhodaya S, Ghazvini K. Evaluation the role of bacterial colonization of Genital tract in pregnancey's complication in hospitalized preterm
10. Boskabadi H, Saghafi N, Najafi A. Assessment the maternal and neonatal complications of premature rupture of membrane after prophylactic adminintration of cefotaxime in pregnant women compared with ampicilline. [PhD thesis]. Mashhad University of Medical Sciences; 2013.
11. Ramsey PS, Lieman JM, Brumfield CG, Carlo W .Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes. Am J Obstet Gynecol 2005; 192: 1162-1166. [DOI:10.1016/j.ajog.2004.11.035]
12. Aziz N, Cheng YW, Caughey AB. Neonatal outcomes in the setting of preterm premature rupture of membranes complicated by chorioamnionitis. J Matern Fetal Neonatal Med 2009; 22: 780-784. [DOI:10.3109/14767050902922581]
13. Hutzal CE, Boyle EM, Kenyon SL, Nash JV, Winsor S, Taylor DJ, et al. Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis. Am J Obstet Gynecol 2008; 199: 620. [DOI:10.1016/j.ajog.2008.07.008]
14. Kenyon S, Boulvain M, Neilson J, et al. Antibiotics for preterm rupture of membranes. Cochrane Database Syst Rev 2013; 12: CD001058. [DOI:10.1002/14651858.CD001058.pub3]
15. Ohlsson A, Shah VS. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev 2009; 3: CD007467. [DOI:10.1002/14651858.CD007467.pub2]
16. Zeng LN, Zhang LL, Shi J, Gu LL, Grogan W, Gargano MM, Chen C. The primary microbial pathogens associated with premature rupture of the membranes in China: a systematic review. Taiwan J Obstet Gynecol 2014; 53: 443-451. [DOI:10.1016/j.tjog.2014.02.003]
17. Stoll BJ, Hansen NI, Sánchez PJ, Faix RG, Poindexter BB, Van Meurs KP, et al. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics 2011; 127: 817-826. [DOI:10.1542/peds.2010-2217]
18. Valkenburg-van den Berg AW, Sprij AJ, Dekker FW, Dörr PJ, Kanhai HH. Association between colonization with Group B Streptococcus and preterm delivery: a systematic review. Acta Obstet Gynecol Scand 2009; 88: 958-967. [DOI:10.1080/00016340903176800]
19. Asindi AA, Archibong EI, Mannan NB. Mother-infant colonization and neonatal sepsis in prelabor rupture of membranes. Saudi Med J 2002; 23: 1270-1274.
20. Murtha AP, Edwards JM. The role of mycoplasma and ureaplasma in adverse pregnancy outcomes. Obstet Gynecol Clin North Am 2014; 41: 615-627. [DOI:10.1016/j.ogc.2014.08.010]
21. Kacerovský M, Pavlovský M, Tosner J. Preterm premature rupture of the membranes and genital mycoplasmas. Acta Medica (Hradec Kralove) 2009; 52: 117-120. [DOI:10.14712/18059694.2016.115]
22. Lee J, Romero R, Kim SM, Chaemsaithong P, Park CW, Park JS, et al. A new anti-microbial combination prolongs the latency period, reduces acute histologic chorioamnionitis as well as funisitis, and improves neonatal outcomes in preterm PROM. J Matern Fetal Neonatal Med 2016; 29: 707-720. [DOI:10.3109/14767058.2015.1020293]
23. Boskabadi H, Maamouri Gh, Mafinejad Sh. Neonatal complications related with prolonged rupture of membranes. Maced J Med Sci 2011; 4: 93-98.
24. Naderi T, Bahrampour A. The role of b-hemolytic streptococci group B and anearobic infections in preterm premature rupture of membrane. J Kerman Univ Med Sci 2011; 8: 95-102.
25. Tille P. Bailey & Scott's Diagnostic Microbiology. 13th Ed. St. Louis, MO: Mosby Inc, Elsevier; 2014.
26. Loeb LJ, Gaither K, Woo KS, Mason TC, Outcomes in gestations between 20 and 25 weeks with preterm premature rupture of membranes. South Med J 2006; 99: 709-712. [DOI:10.1097/01.smj.0000224302.43932.f7]
27. Dechen TC, Sumit K, Ranabir P. Correlates of vaginal colonization with group B streptococci among pregnant women. J Glob Infect Dis 2010; 2: 236-241. [DOI:10.4103/0974-777X.68536]
28. Kerur BM, Vishnu Bhat B, Harish BN, Habeebullah S, Uday Kumar C. Maternal genital bacteria and surface colonization in early neonatal sepsis. Indian J Pediater 2006; 73: 29-32. [DOI:10.1007/BF02758256]

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