Microbial invasion of the amniotic cavity at birth is associated with adverse short-term outcome of preterm infants.
OBJECTIVE
To determine the frequency and clinical significance of microbial invasion of the amniotic cavity at the time of delivery in preterm infants.


METHODS
Prospective cohort study during June 2001 and January 2002. Preterm infants < 33 + 6 weeks of gestation who had amniotic fluid and placental tissue sampled for culture during cesarean section were included.


RESULTS
Of a total of 80 neonates, 42 had negative culture results, 22 had growth of Ureaplasma urealyticum, and 16 had growth of other pathogens. Isolation of Ureaplasma urealyticum was associated with a decreased risk of developing hyaline membrane disease after birth but a more than 20 times increased risk of developing chronic lung disease. Patients with growth of other pathogens had a significantly higher mortality than patients with negative culture results.


CONCLUSIONS
Isolation of miroorganisms from the amniotic cavity at birth is associated with an adverse outcome of the preterm infant. In the light of extremely small numbers of positive blood cultures in preterm infants after birth, we consider it reasonable to recommend routine culturing of amniotic cavity tissues/fluid obtained during cesarean section in order to increase the identification rate of pathogens potentially involved in the pathogenesis of perinatal infections.
Department of Pediatrics, Division of Neonatology, University Hospital Vienna, Austria. angelika.berger@akh-wien.ac.at
Angelika
A
Berger
Armin
A
Witt
Nadja
N
Haiden
Veronika
V
Kretzer
Georg
G
Heinze
Christina
C
Kohlhauser
D002821:Chorioamnionitis / Q000382:microbiology* / Q000401:mortality; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D016869:Ureaplasma Infections / Q000382:microbiology*; D016990:Ureaplasma urealyticum