Abstract
From 30 consecutive cases of premature rupture of the membranes (PROM) and matched controls, specimens from urine, cervix, amniotic fluid, and placenta as well as neonatal nose and throat swabs were investigated bacteriologically and virologically. In addition virus serological investigation was done. Among the PROM cases the anaerobic cervical isolates outnumbered the aerobic ones, and the total number of aerobic as well as anaerobic isolates was less in the control group. The anaerobesB. fragilis andStrept. intermedius were isolated from the cervix, amniotic fluid, or placenta in 23% and 30% of the PROM patients, respectively. None of the controls harbouredB. fragilis, whileStrept. intermedius was isolated from 6.7% of the controls. Group B streptococci were recovered from the mother's cervix in 20% of the PROM patients and in 6.7% among the controls. Four cases of neonatal septicaemia were encountered, and another two cases were clinically suspected, but not microbiologically verified, contributing to a high perinatal mortality rate (17,6%). Of the PROM patients, 27% developed puerperal infection, while none of the control mothers had such complications. The significance of the anaerobic bacteria as well as group B streptococci for the maternal and neonatal outcome in cases of PROM is discussed, and a possible aetiological role of ascending infection in this complication of pregnancy is postulated.
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References
Baker CJ, Barret FF, Yow MD (1975) The influence of advancing gestation on group B streptococcal colonization in pregnant women. Am J Obstet Gynecol 122:820–823
Bartlett JG, Onderdonk AB, Drude E, Coldstein C, Anderka M, Alpert S, McCormack WM (1977) Quantitative bacteriology of the vaginal flora. J Infect Dis 136:271–277
Bergquist G, Hurvell B, Thal E, Vaclavinkova V (1971) Neonatal infections caused by group B streptococci. Scand J Infect Dis 3:209–212
Bergquist G, Hurvell B, Malmborg A-S, Rylander M, Tunell R (1971) Neonatal infections caused by group B streptococci. Scand J Infect Dis 3:157–162
Bobitt JR, Ledger WJ (1976) Obstetric observations in eleven cases of neonatal sepsis due to group B hemolytic streptococcus. Obstet and Gynecol 47:439–442
Bobitt JR, Ledger WJ (1978) Amniotic fluid analyses. Its role in maternal and neonatal infection. Obstet and Gynecol 51:56–62
Carlström G, Jalling B (1970) Cytomegalovirus infections in different groups of paediatric patients. Acta Paedriatr Scand 59:303–309
Chow AW, Leake RD, Yamauchi T, Anthony BF, Guze LB (1974) The significance of anaerobes in neonatal bacteremia. Pediatrics 54:736–745
Christensen P, Kahlmeter G, Jonsson S, Kronvall G (1973) New method for the serological grouping of streptococci with specific antibodies absorbed to protein A-containing staphylococci. Infect Immunol 7:881–885
Cowan ST, Steel KJ (1974) Manual for the identification of medical bacteria. Cambridge University Press, London
Del Bene V, Moore E, Rogers M, Kreutner AK (1977) Bacterial flora of patients with prematurely ruptured membranes. Southern Medical Journal 70:948–954
Dornbusch K, Nord CE, Olsson B, Wadström T (1976) Some properties of coagulaseulgative deoxyribonuclease-producing strains of staphylococci from infections. Med Microbiol Immunol 162:143–152
Facklam RR, Padula JP, Thacker LG, Wortham EC, Sconyers BJ (1974) Presumptive identification of A, B, and D streptococci. Appl Microbiol 27:107–113
Galask RP, Snyder IS (1968) Bacterial inhibition by amniotic fluid. Am J Obstet Gynecol 102:949–955
Goplerud CP, Ohm MJ, Galask RP (1976) Aerobic and anaerobic flora of the cervix during pregnancy and puerperium. Am J Obstet Gynecol 126:858–868
Gunn G, Mishell D, Morton D (1970) Premature rupture of the fetal membranes. Am J Obstet Gynecol 106:469–483
Holdeman LV, Cato EP, Moore WEC (1977) Anaerobe Laboratory Manual, Blacksburg, Virginia Polytechnic Institute and State University, Anaerobe Laboratory
Kittrich M (1963) Zytodiagnostik des Fruchtwasserabflusses mit Hilfe von Nilbau. Geburtshilfe Frauenheilkunde 23:156–163
Knox IC, Hoerner JK (1950) The role of infection in premature rupture of the membranes. Am J Obstet Gynecol 59:190–194
Naeye R, Blanc W (1970) Relation of poverty and race to antenatal infection. New Engl J Med 283:555–560
Naeye R, Tafari N, Judge D, Marboe C (1978) Twins: Causes of perinatal death in 12 United States cities and one African city. Am J Obstet Gynecol 131:267–272
Nahmias AJ, Josey WE, Naib ZM, Freeman MG, Fernandez RJ, Wheeler JH (1971) Perinatal risk associated with maternal genital Herpes simples virus infection. Am J Obstet Gynecol 110:825–837
Nord CE, Lindberg AA, Dahlbäck A (1974) Evaluation of five test-kits — API, AutoTab Enterotube, PathoTec and R/B — for identification of Enterobacteriaceae. Med Microbiol Immunol 159:211–220
Poole PM, Wilson G (1977) Streptococcus milleri in the appendix. J Clin Path 30:937–942
Strangert K, Carlström G, Jeansson S, Nord CE (1976) Infections in preschool children in group day care. Acta Paediatr Scand 65:455–463
Svartz-Malmberg G (1966) Thermolability and mercaptoethanol sensitivity of adenovirus-neutralizing activity in immune and normal animal sera. Acta Path Microbiol Scand 66:359–368
Svartz-Malmberg G, Germanis M (1969) Adenovirus type 8-associated keratoconjunctivitis: Hospital infections and secondary spread in Stockholm, 1967. Scand J Infect Dis 1:161–168
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Evaldson, G., Carlström, G., Lagrelius, A. et al. Microbiological findings in pregnant women with premature rupture of the membranes. Med Microbiol Immunol 168, 283–297 (1980). https://doi.org/10.1007/BF02121812
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DOI: https://doi.org/10.1007/BF02121812