title: The common vaginal commensal bacterium Ureaplasma parvum is associated with chorioamnionitis in extreme preterm labor.
abstract: OBJECTIVE
  To assess the association of vaginal commensal and low-grade pathogenic bacteria including Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, Group B streptococcus (GBS), and Gardnerella vaginalis, in women who delivered preterm at less than 37-week gestation in the presence or absence of inflammation of the chorioamnionitic membranes.
  
  
  METHODS
  A case control study involving women who delivered before 37-week gestation with and without inflammation of chorioamnionitic membranes. A total of 57 placental samples were histologically examined for polymorphonuclear leukocyte infiltration of placental tissue for evidence of chorioamnionitis, and by type-specific nucleic acid amplification for evidence of infection with one or more of the target bacteria. Demographic data were collected for each mother.
  
  
  RESULTS
  Among the 57 placental samples, 42.1% had chorioamnionitis and 24.6% delivered in the second trimester of pregnancy; U. parvum, U. urealyticum, G. vaginalis, and GBS were all detected in the study with respective prevalence of 19.3%, 3.5%, 17.5%, and 15.8%; M. genitalium and M. hominis were not detected. U. parvum was significantly associated with chorioamnionitis (p = 0.02; OR 5.0; (95% CI 1.2-21.5) and was more common in women who delivered in the second (35.7%) compared to the third trimester of pregnancy (13.9%). None of the other bacteria were associated with chorioamnionitis or earlier delivery, and all G. vaginalis-positive women delivered in the third trimester of pregnancy (p = 0.04).
  
  
  CONCLUSIONS
  The detection of U. parvum in placental tissue was significantly associated with acute chorioamnionitis in women presenting in extreme preterm labor.
authors.affiliation: a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .|b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK .
authors.forename: Ciara
authors.initials: C
authors.lastname: Cox
authors.affiliation: c Royal Belfast Hospital for Sick Children, Royal Hospitals Group , Belfast , UK , and.
authors.forename: Nita
authors.initials: N
authors.lastname: Saxena
authors.affiliation: a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .
authors.forename: Alison P
authors.initials: AP
authors.lastname: Watt
authors.affiliation: d Department of Pathology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Gannon
authors.affiliation: a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .
authors.forename: James P
authors.initials: JP
authors.lastname: McKenna
authors.affiliation: a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .|b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK .
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Fairley
authors.affiliation: c Royal Belfast Hospital for Sick Children, Royal Hospitals Group , Belfast , UK , and.
authors.forename: David
authors.initials: D
authors.lastname: Sweet
authors.affiliation: b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK .|c Royal Belfast Hospital for Sick Children, Royal Hospitals Group , Belfast , UK , and.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Shields
authors.affiliation: b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK .
authors.forename: Sara
authors.initials: S
authors.lastname: L Cosby
authors.affiliation: a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .
authors.forename: Peter V
authors.initials: PV
authors.lastname: Coyle
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006194:Gardnerella vaginalis / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis; D006801:Humans; D009175:Mycoplasma Infections / Q000150:complications / Q000175:diagnosis; D045704:Mycoplasma genitalium / Q000302:isolation & purification; D019535:Mycoplasma hominis / Q000302:isolation & purification; D010920:Placenta / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000382:microbiology*; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D014509:Ureaplasma / Q000302:isolation & purification*; D016869:Ureaplasma Infections / Q000150:complications* / Q000175:diagnosis; D016990:Ureaplasma urealyticum / Q000302:isolation & purification; D055815:Young Adult
keywords: Bacteria; PCR; Ureaplasma; intra-amniotic; placenta; pregnancy; prematurity; trimester