Intraamniotic infection with genital mycoplasmas exhibits a more intense inflammatory response than intraamniotic infection with other microorganisms in patients with preterm premature rupture of membranes

Abstract

Objective: The objective of the study was to compare the intensity of inflammatory responses between intraamniotic infection with genital mycoplasmas and intraamniotic infection with other microorganisms.

Study design: We examined the intensity of intraamniotic and maternal inflammatory responses in 99 patients with preterm premature rupture of membranes and a positive amniotic fluid (AF) culture. AF was obtained by transabdominal amniocentesis or at the time of cesarean delivery. Patients were divided according to the recovered microorganisms: (1) genital mycoplasmas (n = 62); (2) other microorganisms (n = 31); or (3) mixed infection (n = 6).

Results: The median AF white blood cell (WBC) count, maternal blood WBC count, and plasma C-reactive protein concentrations were significantly higher in patients with intraamniotic infection with genital mycoplasmas than in those with intraamniotic infection with other microorganisms (P < .05 for each).

Conclusion: Intraamniotic and maternal inflammatory responses are more intense in intraamniotic infection with genital mycoplasmas than in intraamniotic infection with other microorganisms in patients with preterm premature rupture of membranes.

Copyright 2010 Mosby, Inc. All rights reserved.

Figures

Figure 1.

Amniotic fluid (AF) white blood cell (WBC) counts according to each of the microorganisms isolated from AF (data of cases with mixed infection with genital mycoplasmas and other microorganisms were not shown). GBS; group B Streptococcus, SAG; Streptococcus anginosus group, BCC; Burkholderia cepacia complex, GDS; group D Streptococcus, CoNS; coagulase negative Staphylococcus, α-HS; alpha-hemolytic Streptococcus. AF WBC counts (intra-amniotic infection with genital mycoplasmas: median, 306 cells/mm3 [range 0 to >1000 cells/mm3]; intra-amniotic infection with other pathogens: median, 83 cells/mm3 [range 0 to >1000 cells/mm3]; intra-amniotic infection with skin contaminants: median, 69 cells/mm3 [range 0 to >1000 cells/mm3]; p<0.05, by Kruskal-Wallis analysis of variance test).

Figure 2

Maternal blood white blood cell (WBC) counts and maternal plasma C-reactive protein (CRP) concentrations according to each of the microorganisms isolated from amniotic fluid (AF) (data of cases with mixed infection with genital mycoplasmas and other microorganisms were not shown). GBS; group B Streptococcus, SAG; Streptococcus anginosus group, BCC; Burkholderia cepacia complex, GDS; group D Streptococcus, CoNS; coagulase negative Staphylococcus, α-HS; alpha-hemolytic Streptococcus. A, Maternal blood WBC counts (intra-amniotic infection with genital mycoplasmas: median, 11900 cells/mm3 [range, 3390–20800 cells/mm3]; intra-amniotic infection with other pathogens: median, 10410 cells/mm3 [range, 1300–16500 cells/mm3]; intra-amniotic infection with skin contaminants: median, 10570 cells/mm3 [range, 7400–15600 cells/mm3]; p=0.10, by Kruskal-Wallis analysis of variance test). B, Maternal plasma CRP concentrations (intra-amniotic infection with genital mycoplasmas: median, 0.69 mg/dL [range 0.01–4.42 mg/dL]; intra-amniotic infection with other pathogens: median, 0.17 mg/dL [range 0.04–9.39 mg/dL]; intra-amniotic infection with skin contaminants: median, 0.29 mg/dL [range 0.03–2.60 mg/dL]; p=0.11, by Kruskal-Wallis analysis of variance test).