Clinical implications of detection of Ureaplasma urealyticum in the amniotic cavity with the polymerase chain reaction

Bo Hyun Yoon, Roberto Romero, Miha Kim, Eui Chong Kim, Teresa Kim, Joong Shin Park, Jong Kwan Jun

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

OBJECTIVE: The objective of this study was to determine the frequency and clinical significance of the detection of Ureaplasma urealyticum by means of the polymerase chain reaction with specific primers in the amniotic fluid of patients with preterm premature rupture of membranes. STUDY DESIGN: Amniocentesis was performed in 154 patients with preterm premature rupture of membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Ureaplasma urealyticum was detected by means of the polymerase chain reaction with specific primers. Patients were divided into the following 3 groups according to the results of amniotic fluid culture and polymerase chain reaction for U urealyticum: those with a negative amniotic fluid culture and a negative polymerase chain reaction (n = 99), those with a negative amniotic fluid culture but a positive polymerase chain reaction (n = 18), and those with a positive amniotic fluid culture regardless of the results of the polymerase chain reaction (n = 37). Contingency table and survival techniques were used for analysis. RESULTS: (1) U urealyticum was detected by polymerase chain reaction in 28% (43/154) of patients and by culture in 16% (25/154). (2) Among the 43 patients with a positive polymerase chain reaction for U urealyticum, amniotic fluid culture was negative in 42% (18/43). (3) Patients with a negative amniotic fluid culture for U urealyticum but a positive polymerase chain reaction had a significantly shorter median interval from amniocentesis to delivery and a higher amniotic fluid interleukin 6 and white blood cell count than did those with a negative amniotic fluid culture and a negative polymerase chain reaction (interval to delivery; median, 53 hours; range, 0.3-335 hours; vs median, 141 hours; range, 0.1-3552 hours; P < .05; amniotic fluid white blood cell count: median, 513 cells/mm3; range, 1-2295 cells/mm3; vs median, 1 cell/mm3; range, 0-7956 cells/mm3; amniotic fluid interleukin 6: median, 16.6 ng/mL; range, 0.3-53.0 ng/mL; vs median 0.4 ng/mL; range, 0-69.8 ng/mL; P < .0001 for all). (4) Patients with a positive polymerase chain reaction for U urealyticum but a negative amniotic fluid culture had a higher rate of significant neonatal morbidity than did those with both a negative culture and a negative polymerase chain reaction (P < .05). (5) No significant differences in perinatal outcome were observed between patients with a negative culture but a positive polymerase chain reaction and those with a positive amniotic fluid culture. CONCLUSION: (1) Culture techniques for mycoplasmas missed 40% of cases of microbial invasion of the amniotic cavity with U urealyticum. (2) Patients with a positive polymerase chain reaction but a negative amniotic fluid culture are at risk for adverse outcomes. (3) The use of molecular microbiologic techniques is likely to increase the detection of infection among patients with obstetric complications.

Original languageEnglish
Article number31327
Pages (from-to)1130-1137
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume183
Issue number5
DOIs
StatePublished - 1 Jan 2000

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Ureaplasma urealyticum
Amniotic Fluid
Polymerase Chain Reaction
Amniocentesis
Mycoplasma
Leukocyte Count
Interleukin-6
Microbiological Techniques
Culture Techniques
Aerobic Bacteria
Anaerobic Bacteria

Keywords

  • Amniotic fluid
  • Chorioamnionitis
  • Mycoplasma
  • Polymerase chain reaction
  • Premature rupture of membranes
  • Prematuriry
  • Ureaplasma urealyticum

Cite this

@article{68649e03c6ec40b6879e4b856f717048,
title = "Clinical implications of detection of Ureaplasma urealyticum in the amniotic cavity with the polymerase chain reaction",
abstract = "OBJECTIVE: The objective of this study was to determine the frequency and clinical significance of the detection of Ureaplasma urealyticum by means of the polymerase chain reaction with specific primers in the amniotic fluid of patients with preterm premature rupture of membranes. STUDY DESIGN: Amniocentesis was performed in 154 patients with preterm premature rupture of membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Ureaplasma urealyticum was detected by means of the polymerase chain reaction with specific primers. Patients were divided into the following 3 groups according to the results of amniotic fluid culture and polymerase chain reaction for U urealyticum: those with a negative amniotic fluid culture and a negative polymerase chain reaction (n = 99), those with a negative amniotic fluid culture but a positive polymerase chain reaction (n = 18), and those with a positive amniotic fluid culture regardless of the results of the polymerase chain reaction (n = 37). Contingency table and survival techniques were used for analysis. RESULTS: (1) U urealyticum was detected by polymerase chain reaction in 28{\%} (43/154) of patients and by culture in 16{\%} (25/154). (2) Among the 43 patients with a positive polymerase chain reaction for U urealyticum, amniotic fluid culture was negative in 42{\%} (18/43). (3) Patients with a negative amniotic fluid culture for U urealyticum but a positive polymerase chain reaction had a significantly shorter median interval from amniocentesis to delivery and a higher amniotic fluid interleukin 6 and white blood cell count than did those with a negative amniotic fluid culture and a negative polymerase chain reaction (interval to delivery; median, 53 hours; range, 0.3-335 hours; vs median, 141 hours; range, 0.1-3552 hours; P < .05; amniotic fluid white blood cell count: median, 513 cells/mm3; range, 1-2295 cells/mm3; vs median, 1 cell/mm3; range, 0-7956 cells/mm3; amniotic fluid interleukin 6: median, 16.6 ng/mL; range, 0.3-53.0 ng/mL; vs median 0.4 ng/mL; range, 0-69.8 ng/mL; P < .0001 for all). (4) Patients with a positive polymerase chain reaction for U urealyticum but a negative amniotic fluid culture had a higher rate of significant neonatal morbidity than did those with both a negative culture and a negative polymerase chain reaction (P < .05). (5) No significant differences in perinatal outcome were observed between patients with a negative culture but a positive polymerase chain reaction and those with a positive amniotic fluid culture. CONCLUSION: (1) Culture techniques for mycoplasmas missed 40{\%} of cases of microbial invasion of the amniotic cavity with U urealyticum. (2) Patients with a positive polymerase chain reaction but a negative amniotic fluid culture are at risk for adverse outcomes. (3) The use of molecular microbiologic techniques is likely to increase the detection of infection among patients with obstetric complications.",
keywords = "Amniotic fluid, Chorioamnionitis, Mycoplasma, Polymerase chain reaction, Premature rupture of membranes, Prematuriry, Ureaplasma urealyticum",
author = "Yoon, {Bo Hyun} and Roberto Romero and Miha Kim and Kim, {Eui Chong} and Teresa Kim and Park, {Joong Shin} and Jun, {Jong Kwan}",
year = "2000",
month = "1",
day = "1",
doi = "10.1067/mob.2000.109036",
language = "English",
volume = "183",
pages = "1130--1137",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "5",

}

Clinical implications of detection of Ureaplasma urealyticum in the amniotic cavity with the polymerase chain reaction. / Yoon, Bo Hyun; Romero, Roberto; Kim, Miha; Kim, Eui Chong; Kim, Teresa; Park, Joong Shin; Jun, Jong Kwan.

In: American Journal of Obstetrics and Gynecology, Vol. 183, No. 5, 31327, 01.01.2000, p. 1130-1137.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical implications of detection of Ureaplasma urealyticum in the amniotic cavity with the polymerase chain reaction

AU - Yoon, Bo Hyun

AU - Romero, Roberto

AU - Kim, Miha

AU - Kim, Eui Chong

AU - Kim, Teresa

AU - Park, Joong Shin

AU - Jun, Jong Kwan

PY - 2000/1/1

Y1 - 2000/1/1

N2 - OBJECTIVE: The objective of this study was to determine the frequency and clinical significance of the detection of Ureaplasma urealyticum by means of the polymerase chain reaction with specific primers in the amniotic fluid of patients with preterm premature rupture of membranes. STUDY DESIGN: Amniocentesis was performed in 154 patients with preterm premature rupture of membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Ureaplasma urealyticum was detected by means of the polymerase chain reaction with specific primers. Patients were divided into the following 3 groups according to the results of amniotic fluid culture and polymerase chain reaction for U urealyticum: those with a negative amniotic fluid culture and a negative polymerase chain reaction (n = 99), those with a negative amniotic fluid culture but a positive polymerase chain reaction (n = 18), and those with a positive amniotic fluid culture regardless of the results of the polymerase chain reaction (n = 37). Contingency table and survival techniques were used for analysis. RESULTS: (1) U urealyticum was detected by polymerase chain reaction in 28% (43/154) of patients and by culture in 16% (25/154). (2) Among the 43 patients with a positive polymerase chain reaction for U urealyticum, amniotic fluid culture was negative in 42% (18/43). (3) Patients with a negative amniotic fluid culture for U urealyticum but a positive polymerase chain reaction had a significantly shorter median interval from amniocentesis to delivery and a higher amniotic fluid interleukin 6 and white blood cell count than did those with a negative amniotic fluid culture and a negative polymerase chain reaction (interval to delivery; median, 53 hours; range, 0.3-335 hours; vs median, 141 hours; range, 0.1-3552 hours; P < .05; amniotic fluid white blood cell count: median, 513 cells/mm3; range, 1-2295 cells/mm3; vs median, 1 cell/mm3; range, 0-7956 cells/mm3; amniotic fluid interleukin 6: median, 16.6 ng/mL; range, 0.3-53.0 ng/mL; vs median 0.4 ng/mL; range, 0-69.8 ng/mL; P < .0001 for all). (4) Patients with a positive polymerase chain reaction for U urealyticum but a negative amniotic fluid culture had a higher rate of significant neonatal morbidity than did those with both a negative culture and a negative polymerase chain reaction (P < .05). (5) No significant differences in perinatal outcome were observed between patients with a negative culture but a positive polymerase chain reaction and those with a positive amniotic fluid culture. CONCLUSION: (1) Culture techniques for mycoplasmas missed 40% of cases of microbial invasion of the amniotic cavity with U urealyticum. (2) Patients with a positive polymerase chain reaction but a negative amniotic fluid culture are at risk for adverse outcomes. (3) The use of molecular microbiologic techniques is likely to increase the detection of infection among patients with obstetric complications.

AB - OBJECTIVE: The objective of this study was to determine the frequency and clinical significance of the detection of Ureaplasma urealyticum by means of the polymerase chain reaction with specific primers in the amniotic fluid of patients with preterm premature rupture of membranes. STUDY DESIGN: Amniocentesis was performed in 154 patients with preterm premature rupture of membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Ureaplasma urealyticum was detected by means of the polymerase chain reaction with specific primers. Patients were divided into the following 3 groups according to the results of amniotic fluid culture and polymerase chain reaction for U urealyticum: those with a negative amniotic fluid culture and a negative polymerase chain reaction (n = 99), those with a negative amniotic fluid culture but a positive polymerase chain reaction (n = 18), and those with a positive amniotic fluid culture regardless of the results of the polymerase chain reaction (n = 37). Contingency table and survival techniques were used for analysis. RESULTS: (1) U urealyticum was detected by polymerase chain reaction in 28% (43/154) of patients and by culture in 16% (25/154). (2) Among the 43 patients with a positive polymerase chain reaction for U urealyticum, amniotic fluid culture was negative in 42% (18/43). (3) Patients with a negative amniotic fluid culture for U urealyticum but a positive polymerase chain reaction had a significantly shorter median interval from amniocentesis to delivery and a higher amniotic fluid interleukin 6 and white blood cell count than did those with a negative amniotic fluid culture and a negative polymerase chain reaction (interval to delivery; median, 53 hours; range, 0.3-335 hours; vs median, 141 hours; range, 0.1-3552 hours; P < .05; amniotic fluid white blood cell count: median, 513 cells/mm3; range, 1-2295 cells/mm3; vs median, 1 cell/mm3; range, 0-7956 cells/mm3; amniotic fluid interleukin 6: median, 16.6 ng/mL; range, 0.3-53.0 ng/mL; vs median 0.4 ng/mL; range, 0-69.8 ng/mL; P < .0001 for all). (4) Patients with a positive polymerase chain reaction for U urealyticum but a negative amniotic fluid culture had a higher rate of significant neonatal morbidity than did those with both a negative culture and a negative polymerase chain reaction (P < .05). (5) No significant differences in perinatal outcome were observed between patients with a negative culture but a positive polymerase chain reaction and those with a positive amniotic fluid culture. CONCLUSION: (1) Culture techniques for mycoplasmas missed 40% of cases of microbial invasion of the amniotic cavity with U urealyticum. (2) Patients with a positive polymerase chain reaction but a negative amniotic fluid culture are at risk for adverse outcomes. (3) The use of molecular microbiologic techniques is likely to increase the detection of infection among patients with obstetric complications.

KW - Amniotic fluid

KW - Chorioamnionitis

KW - Mycoplasma

KW - Polymerase chain reaction

KW - Premature rupture of membranes

KW - Prematuriry

KW - Ureaplasma urealyticum

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