Advertisement
AJOG Home
Advanced SearchSave search
Full length article| Volume 136, ISSUE 6, P796-804, March 15, 1980

Bacterial colonization of amniotic fluid from intact fetal membranes

  • Joseph M. Miller Jr.
    Affiliations
    Duke University Medical Center, Department of Obstetrics and Gynecology, Division of Perinatal Medicine Durham, North Carolina, USA

    Duke University Medical Center, the Department of Microbiology and Immunology Durham, North Carolina, USA
    Search for articles by this author
  • Marcos J. Pupkin
    Affiliations
    Duke University Medical Center, Department of Obstetrics and Gynecology, Division of Perinatal Medicine Durham, North Carolina, USA

    Duke University Medical Center, the Department of Microbiology and Immunology Durham, North Carolina, USA
    Search for articles by this author
  • Galf B. Hill
    Correspondence
    Reprint requests: Gale B. Hill, Ph.D., P.O. Box 3172, Duke University Medical Center, Durham, North Carolina 27710
    Affiliations
    Duke University Medical Center, Department of Obstetrics and Gynecology, Division of Perinatal Medicine Durham, North Carolina, USA

    Duke University Medical Center, the Department of Microbiology and Immunology Durham, North Carolina, USA
    Search for articles by this author
DOI:https://doi.org/10.1016/0002-9378(80)90458-5
Bacterial colonization of amniotic fluid from intact fetal membranes
Previous ArticleAntepartum fetal evaluation: Development of a fetal biophysical profile
Next ArticleSonar fetal cephalometry: Comparison of bistable with gray scale and real-time techniques
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Except in rare instances, intact membranes have been considered to be a barrier to infection of amniotic fluid. Amniotic fluid was collected from 45 selected patients by amniocentesis or needle amniotomy prior to or duing labor, or by needle aspiration at the time of cesarean section. Fluid was cultured and examined directly by Gram stain. Among 14 patients who were not in labor, only one had growth of bacteria from broth culture [<10 colony-forming units per milliliter (CFU/ml) of amniotic fluid]. Among amniotic fluid cultures from 31 patients in labor, 13 were positive on primary plating media (>102 CFU/ml), five grew in broth only, and 13 were negative. Of the 13 patients with positive cultures of >102 CFU/ml, eight patients had clinical chorioamnionitis; five patients were afebrile and clinically asymptomatic, except that premature labor occurred in three of these patients. Of the amniotic fluid cultures with >102 CFU/ml, six contained only aerobes, five contained only anaerobes, and two contained mixed aerotolerance types. Aerobic bacteria included Haemophilus influenzae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Listeria monocytogenes, group B β-hemolytic streptococci, and coagulase-negative staphylococci. Anaerobic organisms isolated included Fusobacterium nucleatum (on three occasions), Bacteroides corrodens, Bacteroides ochraceus, Bacteroides bivius, and Peptostreptococcus micros. Bacteria and leukocytes observed by oil immersion microscopy on direct Gram stain of unspun amniotic fluid were significantly associated with culture of >102 CFU/ml. Also, the presence of bacteria on Gram stain and >102 CFU/ml from culture were significantly associated with the presence of clinical chorioamnionitis. These data demonstrated a wider spectrum of bacteria capable of colonizing amniotic fluid in the presence of intact membranes than was previously appreciated, indicating that direct Gram stain in addition to culture can provide valuable diagnostic information.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Gosselin O.
        Contribution a l'etude de l'invasion des organismes maternal et foetal par les microbes des voies genitales inferieures au cours du travail.
        H. Vaillant-Carmanne, S A, Liege1945
        • Lewis J.F.
        • Johnson P.
        • Miller P.
        Evaluation of amniotic fluid for aerobic and anaerobic bacteria.
        Am. J. Clin. Pathol. 1976; 65: 58
        • Stroup P.E.
        Amniotic fluid infection and the intact fetal membrane.
        Obstet. Gynecol. 1962; 19: 736
        • Prevedourakis C.N.
        • Strigou-Charalabis E.
        • Kaskarelis D.B.
        Bacterial invasion of amniotic cavity during pregnancy and labor.
        Obstet. Gynecol. 1971; 37: 459
        • Bobitt J.R.
        • Ledger W.J.
        Unrecognized amnionitis and prematurity: A preliminary report.
        J. Reprod. Med. 1977; 19: 8
        • Bobitt J.R.
        • Ledger W.J.
        Amniotic fluid analysis.
        Obstet. Gynecol. 1978; 51: 56
        • Naeye R.L.
        • Peters E.C.
        Amniotic fluid infections with intact membranes leading to perinatal death: A prospective study.
        Pediatrics. 1978; 61: 171
        • Schlievert P.
        • Larsen B.
        • Johnson W.
        • Galask R.P.
        Bacterial growth inhibition by amniotic fluid.
        Am. J. Obstet. Gynecol. 1975; 122: 809
        • Larsen Jr., J.W.
        • Weis K.R.
        • Lenihan Jr., J.P.
        • Crumrine M.
        • Heggers J.P.
        Significance of neutrophils and bacteria in the amniotic fluid of patients in labor.
        Obstet. Gynecol. 1976; 47: 143
        • Listwa H.M.
        • Dobek A.S.
        • Carpenter J.
        • Gibbs R.S.
        The predictability of intrauterine infection by analysis of amniotic fluid.
        Obstet. Gynecol. 1976; 48: 31
      11. Holdeman L.V. Cato E.P. Moore W.E.C. Anaerobe Laboratory Manual, Blacksburg. Virginia Polytechnic Institute and State University, Virginia1977
        • Blanc W.A.
        Pathways of fetal and early neonatal infection.
        J. Pediatr. 1961; 59: 473
        • Wingate W.B.
        • Iffy L.
        • Kelly J.V.
        • Birnbaum S.
        Chorioamnionitis.
        in: Romney S.L. Gray M.J. Little A.B. Gynecology and Obstetrics—The Health Care of Women. McGraw-Hill Book Co., Inc, New York1975: 332
        • Eickhoff T.C.
        • Klein J.O.
        • Daly A.K.
        • Ingall D.
        • Finland M.
        Neonatal sepsies and other infections due to group B beta-hemolytic streptococci.
        N. Engl. J. Med. 1964; 271: 1221
        • Gibson M.
        • Williams P.P.
        Haemophilus influenzae amnionitis associated with prematurity and premature membrane rupture.
        Obstet. Gynecol. 1978; 52: 70s
        • Harwick H.J.
        • Iuppa J.B.
        • Fekety F.R.
        Microorganisms and amniotic fluid.
        Obstet. Gynecol. 1969; 33: 256
        • Holdeman L.V.
        • Johnson J.L.
        Bacteroides disiens sp. nov. and Bacteroides bivius sp. nov. from human clinical infections.
        Int. J. Systemic Bacteriol. 1977; 27: 337
        • Hill G.B.
        • Gall S.A.
        • Kohan A.P.
        • Ayers O.M.
        Bacteroides bivius, Bacteroides disiens, and other anaerobic gram-negative bacilli in the vaginal flora of premenopausal women.
        in: Abstracts of the 78th Annual Meeting of the American Society for Microbiology. American Society for Microbiology, Washington1978: 282
        • Goplerud C.P.
        • Ohm M.J.
        • Galask R.P.
        Aerobic and anaerobic flora of the cervix during pregnancy and the puerperium.
        Am. J. Obstet. Gynecol. 1976; 126: 858
        • Thadepalli H.
        • Bach V.T.
        • Davidson Jr., E.C.
        Antimicrobial effect of amniotic fluid.
        Obstet. Gynecol. 1978; 52: 198
        • Thadepalli H.
        • Appleman M.D.
        • Maidman J.E.
        • Arce J.J.
        • Davidson Jr., E.C.
        Antimicrobial effect of amniotic fluid against anaerobic bacteria.
        Am. J. Obstet. Gynecol. 1977; 127: 250

      Article Info

      Publication History

      Accepted: June 7, 1979
      Received: March 1, 1979

      Identification

      DOI: https://doi.org/10.1016/0002-9378(80)90458-5

      Copyright

      © 1980 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2022 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX