The congruity between urine and cervical swab cultures in pregnant women with versus without amniotic fluid infection.
BACKGROUND
We observed the congruity of bacteria found in urine and cervix of pregnant women with amniotic fluid infection (AFI) compared to healthy controls.


METHODS
Over three years, we prospectively analysed urine and cervical swabs cultures in 120 pregnant women in gestational week 16-20. The patient population was divided in two groups: group I patients had clinical symptoms of AFI. The rest of the patients were designated as healthy controls (group II). Congruity between findings in both groups was observed. In patients with bacterial growth, antibiotic treatment was initiated as recommended and once ended - culture probes were repeated.


RESULTS
The rates of nonsignificant and significant bacteriuria were doubled in group I. Fifty-five percent (n = 33) of patients in group I had identical bacteria cultured both from the urine sample and cervical swab, in contrast to only 13.3 % in group II. Congruity was most pronounced for Klebsiella species and E. coli, the later being single most dominant isolate in regards to both cultures. After antimicrobial treatment, microbial eradication occurred in 15 patients (45.5 %). The observed incidences of abortions and preterm deliveries were significantly lower in patients with microbial eradication versus patients with microbial persistence.


CONCLUSIONS
Patients with clinical symptoms of AFI have high risk for bacteriuria identical to bacterial culture from cervical swab. Antimicrobial treatment was effective only partially where indicated. Screening for eradication is recommended and consensus on the most appropriate therapy is needed.
Mavrova-Risteska
L
L
Department of Gynecology and Obstetrics, Johann Wolfgang Goethe University, Frankfurt/M, Germany. loretamavrova@yahoo.com
Hrgovic
Z
Z
Curzik
D
D
Kissler
S
S
Kaufmann
M
M
Gaetje
R
R
D000653:Amniotic Fluid / Q000382:microbiology* / Q000821:virology; D001424:Bacterial Infections / Q000175:diagnosis / Q000652:urine; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000652:urine*; D014626:Vaginal Smears