AMNIOTIC-FLUID U-UREALYTICUM COLONIZATION - SIGNIFICANCE FOR MATERNALPERIPARTAL INFECTIONS AT TERM

The aim of this study was to examine the relationship between maternal peripartal infectious morbidity and amniotic fluid colonization by U. urealyticum. Amniotic fluid specimens for bacterial and mycoplasmal c ultures were obtained by aspiration at nonelective cesarean section fr om 98 pregnant women. Amniotic fluid cultures revealed micro-organisms in 70 (71%) parturients and U. urealyticum was the most frequently is olated species, detected in the specimens from 38 (39%) women. In the total study population, the prevalence of clinically defined infectiou s morbidity was 26%, including 8 (8%) patients with chorioamnionitis, 11 (11%) with endometritis, 5 (5%) with urinary tract infection, and 4 (4%) with wound infection. A significant association between the amni otic fluid U. urealyticum colonization and increased maternal peripart al infectious morbidity was observed (p<0.0027; relative risk 4.1; 95% confidence limits 1.6 to 10.7). Amniotic fluids positive for U. ureal yticum were significantly more often positive for other potentially pa thogenic bacteria (p<0.0024) and particularly for Bacteroides spp. (p< 0.0074). Our results support the existence of an association between a mniotic fluid U. urealyticum invasion and maternal infectious morbidit y. However, U. urealyticum was not usually isolated alone from amnioti c fluids but combined with other pathogenic bacteria, the severity of infections were not enhanced when U. urealyticum was present and partu rients with diagnosed infections managed well without specific antibio tic against U. urealyticum. Hence, it appears that the significance of U. urealyticum in maternal infections in this study population was ma inly based on its interactions with other bacteria.