Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin.
Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin.
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阴道营养不良增加了早产胎儿膜破裂，新生儿败血症的风险，并因红霉素而加剧。
DOI：
10.1186/s12916-017-0999-x
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发表时间：
2018-01-24
期刊：
影响因子：
9.3
通讯作者：
MacIntyre DA
中科院分区：
文献类型：
--
作者：
Brown RG;Marchesi JR;Lee YS;Smith A;Lehne B;Kindinger LM;Terzidou V;Holmes E;Nicholson JK;Bennett PR;MacIntyre DA
30% 的早产发生在早产前胎膜破裂 (PPROM)，是早发新生儿败血症的危险因素。由于PPROM与上行性阴道感染密切相关，预防性抗生素被广泛使用。与 PPROM 相关的阴道微生物群组成的演变以及抗生素对细菌组成的影响尚不清楚。我们使用基于 MiSeq 的 16S rRNA 基因扩增子测序前瞻性评估了 PPROM 之前和之后的阴道微生物群，并检查了红霉素预防对细菌负荷和群落结构的影响。与足月妊娠相比，阴道菌群失调以乳杆菌属为特征。大约三分之一的病例在胎膜破裂之前存在耗尽（0% vs. 27%，P = 0.026），并在胎膜破裂后持续存在（31%，P = 0.005）。红霉素治疗加剧了阴道生态失调（47%，P = 0.00009），特别是在最初被乳杆菌定植的女性中。乳酸菌消耗和 Sneathia spp 相对丰度增加。与随后的滑囊炎和早发性新生儿败血症有关。我们的数据表明，阴道微生物群组成是后续未足月胎膜早破的危险因素，并与不良的短期孕产妇和新生儿结局相关。这凸显了阴道微生物群作为未足月胎膜早破的一个潜在可改变的产前危险因素，并建议重新审查红霉素治疗未足月胎膜早破的常规使用。本文的在线版本 10.1186/s12916-017-0999-x) 包含补充材料，可供授权用户使用。
Preterm prelabour rupture of the fetal membranes (PPROM) precedes 30% of preterm births and is a risk factor for early onset neonatal sepsis. As PPROM is strongly associated with ascending vaginal infection, prophylactic antibiotics are widely used. The evolution of vaginal microbiota compositions associated with PPROM and the impact of antibiotics on bacterial compositions are unknown. We prospectively assessed vaginal microbiota prior to and following PPROM using MiSeq-based sequencing of 16S rRNA gene amplicons and examined the impact of erythromycin prophylaxis on bacterial load and community structures. In contrast to pregnancies delivering at term, vaginal dysbiosis characterised by Lactobacillus spp. depletion was present prior to the rupture of fetal membranes in approximately a third of cases (0% vs. 27%, P = 0.026) and persisted following membrane rupture (31%, P = 0.005). Vaginal dysbiosis was exacerbated by erythromycin treatment (47%, P = 0.00009) particularly in women initially colonised by Lactobacillus spp. Lactobacillus depletion and increased relative abundance of Sneathia spp. were associated with subsequent funisitis and early onset neonatal sepsis. Our data show that vaginal microbiota composition is a risk factor for subsequent PPROM and is associated with adverse short-term maternal and neonatal outcomes. This highlights vaginal microbiota as a potentially modifiable antenatal risk factor for PPROM and suggests that routine use of erythromycin for PPROM be re-examined. The online version of this article 10.1186/s12916-017-0999-x) contains supplementary material, which is available to authorized users.
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影响因子：
7.7
作者：
Cousens S;Blencowe H;Gravett M;Lawn JE
通讯作者：
Lawn JE
影响因子：
3.7
作者：
Aagaard K;Riehle K;Ma J;Segata N;Mistretta TA;Coarfa C;Raza S;Rosenbaum S;Van den Veyver I;Milosavljevic A;Gevers D;Huttenhower C;Petrosino J;Versalovic J
通讯作者：
Versalovic J
影响因子：
3.7
作者：
Fortner KB;Grotegut CA;Ransom CE;Bentley RC;Feng L;Lan L;Heine RP;Seed PC;Murtha AP
通讯作者：
Murtha AP
影响因子：
17.1
作者：
Gajer P;Brotman RM;Bai G;Sakamoto J;Schütte UM;Zhong X;Koenig SS;Fu L;Ma ZS;Zhou X;Abdo Z;Forney LJ;Ravel J
通讯作者：
Ravel J
DOI：
10.1073/pnas.1002601107
发表时间：
2010-06-29
影响因子：
11.1
作者：
Dominguez-Bello, Maria G.;Costello, Elizabeth K.;Knight, Rob
通讯作者：
Knight, Rob