Submitted by Jim K on Fri, 2006-04-07 07:15

While this is not Cpn, I felt it was an important related finding as it demonstrates infectious bacterial source behind a previously overlooked cause in a phenomena (look at the Cpn & Animal materials on our site to appreciate how much Cpn could be linked to spontaneous abortions and miscarraige). It also suggests that, like Cpn, blood findings are not especially useful to detect infection. In this case the researcher notes:

"The bacteria were not detected in the patient's blood, but they had likely been cleared from the blood by the immune system before they could be detected," Dr. Han said.

Many relevant parallels."The study is an eye-opener," Dr. Han said. "It shows that oral bacteria can get into the uterus."       bacterium genus Bergeyella      Ureaplasma urealyticum       Mycoplasma hominisOral Bacteria Linked to Uterine Infections and Preterm Birth By Jeff Minerd, MedPage Today Staff WriterReviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. MedPage Today - Little Falls,NJ,USA - April 06, 2006 http://www.medpagetoday.com/OBGYN/Pregnancy/tb/3017CLEVELAND, April 6 - The first hard evidence has been uncovered that bacteria in the mouth may find their way to the uterus, causing uterine infections that can lead to preterm birth in pregnant women. A newly discovered and as yet unnamed species of the bacterium genus Bergeyella was found in the mouth and amniotic fluid of a woman with a uterine infection who gave birth prematurely (24 weeks), reported microbiologist Yiping W. Han, Ph.D., of Case Western Reserve here. However, the bacterium was not detected in a vaginal swab, as might be expected. The finding confirmed what some scientists have suspected, that intrauterine infections don't always "ascend" from the genital tract but can "descend" from the oral cavity, Dr. Han and colleagues said in the April issue of the Journal of Clinical Microbiology. The study included 19 pregnant women undergoing transabdominal amniocentesis because of preterm labor or threatened preterm labor. Amniotic fluid, blood samples, vaginal swabs, and oral swabs were collected from each woman and analyzed for bacterial DNA via polymerase chain reaction (PCR) and nucleotide sequencing. The species of Bergeyella was detected in the mouths of all 14 women tested, but in the amniotic fluid of only one patient. This woman had been diagnosed with a uterine infection based on an elevated white blood cell count and a low glucose level in the amniotic fluid. She went into labor, induced because of the infection, and delivered her baby at 24 weeks' gestation. Subsequent analysis of her placenta revealed severe and diffused chorioamnionitis and fetal vasculitis involving the umbilical cord and chorionic plate, which was the presumed cause of her preterm labor. "Intrauterine infection with Bergeyella has never been reported before. Where could the bacteria come from?" the investigators asked. Because the bacteria were not detected in the vaginal tract, the investigators hypothesized they were transmitted to the uterus from the mouth via the bloodstream. The bacteria were not detected in the patient's blood, but they had likely been cleared from the blood by the immune system before they could be detected, Dr. Han said. Although periodontal disease has been implicated in preterm birth, the patient showed no evidence of periodontal disease, the researchers noted. "The study is an eye-opener," Dr. Han said. "It shows that oral bacteria can get into the uterus." The study also suggested that more than the usual bacterial suspects may be responsible for uterine infection and resulting preterm birth, Dr. Han added. The usual suspects are known vaginal flora such as Ureaplasma urealyticum or Mycoplasma hominis. But Bergeyella, a little-known, rod-shaped, Gram-negative bacteria associated with dog and cat bite wounds, had not been thought to be an important component of the oral or vaginal flora. One reason Bergeyella may have been overlooked previously is that it is difficult to grow in culture. As much as 60% to 70% of oral bacteria can not be detected by growing on culture. The current study detected Bergeyella because it used PCR amplification of bacterial DNA rather than traditional culturing techniques, Dr. Han said. While suggestive, the study's findings do not yet support routine analysis of pregnant women's oral or vaginal flora to identify those who may be at risk for uterine infection, Dr. Han said. "That is the question we want to ask now," she said. Her research is examining whether particular components or oral or vaginal flora are associated with increased risk for uterine infection or preterm birth. The mother and baby from the study are healthy and doing well, Dr. Han said. ###--------------------------------------------MedPage Today Action Points:   Explain to patients that while suggestive, the study's findings do not support routine analysis of pregnant women's oral or vaginal flora to identify those who may be at risk for uterine infection --------------------------------------------Primary source:  Journal of Clinical Microbiology--------------------------------------------Source reference:   Yiping Han et al. Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth. Journal of Clinical Microbiology 2006; 44:1475-1483. --------------------------------------------© 2004-6 MedPage Today, LLC. All Rights Reserved.

Good grief, You know this finding is earthshaking, and for those of us here onthis site it is a familiar story: a germ that you can't find causing a profoundly negative outcome. Yet general medical practitioners will not "know" this for a long time. IT'll have to be repliated, others will have to agree that it happens as they say it does. The interesting thing from this is that the one mom who was cultured positive and who's placenta showed obvious signs is a "no brainer" but the question becomes for those who had no positive culture but who also had threatened early labor, was it there for them too and just missed? and what does that look like in clinical practice, in other words how does th is impact tha advice and care given to patients? It'll b be decades before that is anwered...
marie

On CAP since Sept '05 for MS, RA, Asthma, sciatica. EDSS at start 5.5.(early cane) Now 6 (cane full time) Originally on: Doxy 200, Azith 3x week, Tini cont. over summer '07, Revamp of protocol in Summer '08 by Stratton due to functional loss; clarithro