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Vaginal bacterial dysbiosis increases risk of preterm fetal membrane rupture, funisitis and neonatal sepsis and is adversely effected by erythromycin treatment

ABSTRACT: Vaginal microbial dysbiosis increases risk of preterm pre-labor rupture of the fetal membranes, funisitis and neonatal sepsis and is adversely effected by oral administration of erythromycin.

PROVIDER: PRJEB21325 | ENA |

REPOSITORIES: ENA

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			Action	DRS
	ERR2009190_1.fastq.gz	Fastqsanger.gz
	ERR2009190_2.fastq.gz	Fastqsanger.gz
	ERR2009200_1.fastq.gz	Fastqsanger.gz
	ERR2009200_2.fastq.gz	Fastqsanger.gz
	ERR2009210_1.fastq.gz	Fastqsanger.gz

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Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin.

Project description:BackgroundPreterm 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.MethodsWe 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.ResultsIn 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.ConclusionsOur 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.

| S-EPMC5782380 | biostudies-literature

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