SEARCHCOHORTpediatrics, obstetrics and gynecology

cohort·pediatrics, obstetrics and gynecology, infectious disease, epidemiology·PMC10009945

Vaginal and neonatal microbiota in pregnant women with preterm premature rupture of membranes and consecutive early onset neonatal sepsis

BMC Medicine · 14 authors, 4 centres

AI SUMMARY

FIDELITY 100%

POPULATIONPregnant women with preterm premature rupture of membranes (PPROM) and their neonates

INTERVENTIONMicrobiota analysis by 16S rRNA gene sequencing and standard antibiotic therapy

COMPARISONMicrobial composition between groups with and without EONS

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

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TL;DR

This prospective cohort study analyzed vaginal and neonatal microbiota in women with preterm premature rupture of membranes (PPROM) to see if microbial patterns could predict early-onset neonatal sepsis (EONS).

Full summary

948 CHARS

This prospective multicenter cohort study analyzed the vaginal microbiota of 78 women with PPROM and the microbiota of their 89 neonates using 16S rRNA gene sequencing. The central result was that vaginal microbiota at birth showed potential to predict EONS, with specific taxa like *Escherichia/Shigella* and *Facklamia* as risk factors, and *Anaerococcus obesiensis* and *Campylobacter ureolyticus* as protective. Neonatal meconium communities could also predict EONS, with *Bifidobacterium longum* identified as protective. Standard antibiotic therapy was associated with significant changes in vaginal microbial communities, including a depletion of *Lactobacillus* spp. and an enrichment of *Ureaplasma parvum*. Limitations include the relatively small sample size and the need for validation in extended cohorts. The findings suggest that microbiota analysis could form the basis for individualized risk assessment for EONS in PPROM patients.

PICO

PPOPULATION

Pregnant women with preterm premature rupture of membranes (PPROM) and their neonates

IINTERVENTION

Microbiota analysis by 16S rRNA gene sequencing and standard antibiotic therapy

OOUTCOME

Development of early-onset neonatal sepsis (EONS)

STUDY TYPE

cohort

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10009945

Vaginal and neonatal microbiota in pregnant women with preterm premature rupture of membranes and consecutive early onset neonatal sepsis

BMC Medicine

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ABSTRACT

Background Preterm premature rupture of membranes (PPROM), which is associated with vaginal dysbiosis, is responsible for up to one-third of all preterm births. Consecutive ascending colonization, infection, and inflammation may lead to relevant neonatal morbidity including early-onset neonatal sepsis (EONS). The present study aims to assess the vaginal microbial composition of PPROM patients and its development under standard antibiotic therapy and to evaluate the usefulness of the vaginal microbiota for the prediction of EONS. It moreover aims to decipher neonatal microbiota at birth as possible mirror of the in utero microbiota. Methods As part of the PEONS prospective multicenter cohort study, 78 women with PPROM and their 89 neonates were recruited. Maternal vaginal and neonatal pharyngeal, rectal, umbilical cord blood, and meconium microbiota were analyzed by 16S rRNA gene sequencing. Significant differences between the sample groups were evaluated using permutational multivariate analysis of variance and differently distributed taxa by the Mann–Whitney test. Potential biomarkers for the prediction of EONS were analyzed using the MetaboAnalyst platform. Results Vaginal microbiota at admission after PPROM were dominated by Lactobacillus spp. Standard antibiotic treatment triggers significant changes in microbial community (relative depletion of Lactobacillus spp. and relative enrichment of Ureaplasma parvum ) accompanied by an increase in bacterial diversity, evenness and richness. The neonatal microbiota showed a heterogeneous microbial composition where meconium samples were characterized by specific taxa enriched in this niche. The vaginal microbiota at birth was shown to have the potential to predict EONS with Escherichia/Shigella and Facklamia as risk taxa and Anaerococcus obesiensis and Campylobacter ureolyticus as protective taxa. EONS cases could also be predicted at a reasonable rate from neonatal meconium communities with the protective taxa Bifidobacterium longum , Agathobacter rectale , and S. epidermidis as features. Conclusions Vaginal and neonatal microbiota analysis by 16S rRNA gene sequencing after PPROM may form the basis of individualized risk assessment for consecutive EONS. Further studies on extended cohorts are necessary to evaluate how far this technique may in future close a diagnostic gap to optimize and personalize the clinical management of PPROM patients. Trial registration NCT03819192, ClinicalTrials.gov. Registered on January 28, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12916-023-02805-x.

CITATION EXPORT

Luiz Gustavo dos Anjos Borges, Jana Pastuschek, Yvonne Heimann et al.. Vaginal and neonatal microbiota in pregnant women with preterm premature rupture of membranes and consecutive early onset neonatal sepsis. BMC Medicine. (2023). https://doi.org/10.1186/s12916-023-02805-x

AUTHORS

14 · 4 CENTRES

Luiz Gustavo dos Anjos Borges, Jana Pastuschek, Yvonne Heimann, Kristin Dawczynski, Ekkehard Schleußner, Dietmar H. Pieper, Janine Zöllkau, Michael Bergner, Roland Haase, Johannes Stubert, Dirk Olbertz, Iris Plumeier, Silke Kahl, Ann Kathrin Heroven

1grid.7490.a0000 0001 2238 295XMicrobial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Brunswick, Germany
2grid.275559.90000 0000 8517 6224Department of Obstetrics, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
3grid.275559.90000 0000 8517 6224Center for Sepsis Control and Case (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
4grid.275559.90000 0000 8517 6224Department of Pediatrics, Section Neonatology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany