Possible Role of Bacterial and CMV Infections in Miscarriages
DOI:
https://doi.org/10.61841/5jqcza73Keywords:
Miscarriages, Cytomegalovirus, Bacterial Vaginosis, Bacterial InfectionAbstract
Background: Miscarriages are considered to be the most common complication in pregnancy. The incidence of miscarriages in clinically established pregnancies (over the sixth gestational week) is approximately 12%–15%. Several possible causes of miscarriage have been considered, the major ones being genetic abnormalities of the fetus. It has been established that more than 50% of miscarried fetuses are genetically abnormal.
Aim of study: To determine the role of CMV and bacterial infections in miscarriages in Hilla city.
Methods: One hundred thirty (130) samples of blood and high vaginal swabs were collected from married women with vaginosis who visited the hospital of Babylon City and private clinics with ages ranging from 18 to 47 years. All the patients and control sera were screened for IgG antibodies to CMV, which is useful to detect previous exposure to CMV. Cervical swab/secretion was inoculated into nutrient agar and was incubated at 37°C for 24 hours aerobically. The isolates were identified on the basis of colony morphology from colony Gram staining, and colonies were identified as negative and positive isolates in the compacted-vatik-2 system. Some bacteria were detected by the PCR technique.
Results: The higher concentration of IgG at age group (18-23) and at age group (24-29) is about 73.52600 ± 2.663314 and 55.69333 ± 2.904884, respectively, and there is an absence of IgM level. The highest rate of isolation of bacteria from vaginitis in women with abortions is Lactobacillus at 22 (33.84%), followed by Escherichia coli at 10 (15.38%), Staphylococcus aureus at 10 (15.38%), Staphylococcus pyogenes at 7 (10.76%), Proteus at 5 (7.69%), Pseudomonas aeruginosa at 4 (6.17%), Streptococcus agalactiae at 4 (6.15%), and Listeria monocytogenes at 3 (4.62%).
Conclusion: CMV and bacterial infection played important roles in miscarriages.
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References
[1] Zinaman MJ, Clegg ED, Brown CC, O’Connor J, Selevan SG. (1996). Estimates of human fertility and
pregnancy loss. Fertil Steril; 65: 503–9.
[2] Edmonds DK, Lindsay KS, Miller JF, Williamson E, Wood PJ. (1982). Early embryonic mortality in
women. Fertil Steril; 38: 447–53.
[3] Wolf GC and Horger EO. (1995). Indications for examination of spontaneous abortion specimens: a
reassessment. Am J Obstet Gynecol; 173: 1364–8.
[4] McDonald HM and Chambers HM. (2000). Intrauterine infection and spontaneous midgestation abortion:
Is the spectrum of microorganisms similar to that in preterm labor? Infect Dis Obstet Gynecol; 8: 220–7.
[5] Handsfield HH, Chandler SH, Caine VA. (1985). Cytomegalovirus infection in sex partners: evidence for sexual transmission. J Infect Dis; 151: 344–8.
[6] Pignatelli S, Dal Monte P, Landini MP. (2001). gpUL73 (gN) genomic variants of human cytomegalovirus isolates are clustered into four distinct genotypes. J Gen Virol; 82: 2777–84.
[7] Schwebke JR. (2009). New concepts in the etiology of bacterial vaginosis,” Current Infectious Disease Reports. 11(2): 143–147.
[8] Marrazzo JM. B (2011). Interpreting the epidemiology and natural history of bacterial vaginosis: are we still confused?” Anaerobe 17(4): 186–190.
[9] Klebanoff MA, Schwebke JR, Zhang J, Nansel TR, Yu KF, and Andrews WW. (2004). Vulvovaginal
symptoms in women with bacterial vaginosis,” Obstetrics & Gynecology, 104(2): 267–272.
[10] Gillet E, Meys JFA, Verstraelen H. (2011). Bacterial vaginosis is associated with uterine cervical human
papillomavirus infection: a meta-analysis,” BMC Infectious Diseases, 11, article 10.
[11] Ravel J, Gajer P, Abdo Z. (2011) Vaginal microbiome of reproductive-age women,” Proceedings of the
National Academy of Sciences of the United States of America, vol. 108, supplement 1, pp. 4680–4687,
[12] Pereira LH, Embil JA, Haase DA, Manley KM. (1990). Cytomegalovirus infection among women
attending a sexually transmitted disease clinic: association with clinical symptoms and other sexually
transmitted diseases. Am J Epidemiol.; 131: 683–92.
[13] Goldenberg RL, Hauth JC, Andrews WW. (2000). Intrauterine infection and preterm delivery. N Engl J
Med; 342: 1500 –7.
[14] Kirakoya-SF, Nagot N, Defer MC. (2011). Epidemiology of herpes simplex virus type 2 infection in rural
and urban Burkina Faso. Sex Transm Dis; 38:117–23.
[15] Kirakoya-SF, Nagot N, Defer MC, (2008). Bacterial vaginosis among pregnant women in Burkina Faso.
Sex Transm Dis; 35: 985–9.
[16] Madhivanan P, Krupp K, Chandrasekaran V. (2008). Prevalence and correlates of bacterial vaginosis
among young women of reproductive age in Mysore, India. Indian J Med Microbiol; 26:132–7.
[17] MacFaddin JF., 2000. Biochemical tests for identification of medical bacteria. 3rd ed. Baltimore, Md.:
Lippincott Williams and Wilkins.
[18] Amsel, R., Totten, PA., Spiegel, CA., Chen, KC., Eschenbach, D., and Holmes, KK. (1983). Nonspecific
Vaginitis: diagnostic criteria and microbial and epidemiologic associations. The American journal of
Medicine, 74(1), 14-22.
[19] Nugent RP, Krohn MA, and Hillier SL. (1991). Reliability of diagnosing bacterial vaginosis is improved
by a standardized method of Gram stain interpretation. Journal of Clinical Microbiology. 29(2): 297-301.
[20] Fredricks, DN, Fiedler, TL, Thomas, KK, Oakley, BB & Marrazzo, JM. (2007). Targeted PCR for detection of
vaginal bacteria associated with bacterial vaginosis. Journal of clinical microbiology, 45(10), 3270-3276.
[21] Saraswathy TS, Az-Ulhusna A, Asshikin RN, Suriani S & Zainah S. (2011). Seroprevalence of
cytomegalovirus infection in pregnant women and associated role in obstetric complications: a preliminary
Study. Infertility, 1(1), 1.
[22] Jückstock J, Rothenburger M, Friese K & Traunmüller F. (2015). Passive immunization against congenital
Cytomegalovirus infection: current state of knowledge. Pharmacology, 95(5-6), 209-217.
[23] Nigro, G., & Adler, SP. (2011). Cytomegalovirus infections during pregnancy. Current Opinion in Obstetrics
and Gynecology, 23(2), 123-128.
[24] Yudin MH, Landers DV, Meyn L, & Hillier SL. (2003). Clinical and cervical cytokine response to
treatment with oral or vaginal metronidazole for bacterial vaginosis during pregnancy: a randomized
trial. Obstetrics & Gynecology, 102(3), 527-534.
[25] Boeckh, M. & Geballe, A. P. (2011). Cytomegalovirus: pathogen, paradigm, and puzzle. The Journal of
Clinical Investigation, 121(5), 1673-1680.
[26] Kalter H. (2010). Teratology in the twentieth century plus ten. Springer Science & Business Media.
[27] Mahdi NK and Al Hamdani MM. (1998). Sexually transmitted diseases among women with habitual
abortion.Eastern Mediterranean Health Journal; 4(1):161-163.
[28] Garg KB, Ganguli I, Das R, and Talwar GP. (2009). Spectrum of Lactobacillus species present in healthy
vagina of Indian women. Indian Journal of Medical Research, 129(6), 652-657.
[29] Borges S, Silva J & Teixeira P. (2014). The role of lactobacilli and probiotics in maintaining vaginal
health. Archives of gynecology and obstetrics, 289(3), 479-489.
[30] Sinyakova AA, Shipitsyna EV, Budilovskaya OV, Martikaynen ZM, Grigoryev AN, Bolotskikh VM, & Savicheva AM. (2018). Vaginal microbiota in the first trimester of pregnancy in women with a history of miscarriage. Journal of Obstetrics and Women's Diseases, 67(5), 32-41.
[31] Goldenberg RL, Culhane JF, Iams JD & Romero R. (2008). Epidemiology and causes of preterm birth. The Lancet, 371(9606), 75-84.
[32] Al-Taweel RS. (2016). Vaginal Flora among Women with and without Bacterial Vaginosis. Journal of al-Qadisiyah for Pure Science (quarterly), 4(21), 39-50.
[33] Guay DR. (2008). Contemporary management of uncomplicated urinary tract infections. Drugs, 68(9), 1169-1205.
[34] Schito GC, Naber KG, Botto H, Palou J, Mazzei T, Gualco L & Marchese A. (2009). The ARESC study:
an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract
infections. International journal of antimicrobial agents, 34(5), 407-413.
[35] Razzak MSA, Al-Charrakh AH & AL-Greitty BH. (2011). Relationship between lactobacilli and
opportunistic bacterial pathogens associated with vaginitis. North American journal of medical
Sciences, 3(4), 185.
[36] Abed KA & Kandala NJ. (2016). Molecular and Bacteriological Detection of Some Bacterial Vaginosis
Associate Bacteria in Women. Iraqi Journal of Science, 57(3B), 1926-1936.
[37] Bhat G, KotiGadd ES, and Kotian S. (2012). Effect of pH on the Adherence, Surface Hydrophobicity and
The Biofilm Formation of Gardnerella Vaginalis. Journal of Clinical and Diagnostic Research, 6; 967–9.
[38] Bosshard PP, Abels S, Zbinden R, Böttger EC & Altwegg M. (2003). Ribosomal DNA sequencing for
Identification of aerobic gram-positive rods in the clinical laboratory (an 18-month evaluation). Journal of
Clinical Microbiology, 41(9), 4134-4140.
[39] Russo R, Karadja E & De Seta F. (2019). Evidence-based mixture containing Lactobacillus strains and
lactoferrin to prevent recurrent bacterial vaginosis: a double blind, placebo controlled, randomised clinical
trial. Beneficial microbes, 10(1), 19-26.
[40] Shipitsyna E, Roos A, Datcu R, Hallén A, Fredlund H, Jensen JS, and Unemo M. (2013). Composition of
the vaginal microbiota in women of reproductive age—sensitive and specific molecular diagnosis of
Is bacterial vaginosis possible?. PLoS One, 8(4), e60670.
[41] Bunyan IA, Abdul-Lateef LA, and Al-Rubaeaee AA. (2018). Genotyping of vaginalysin gene of
Gardnerella vaginalis isolated from preterm labor patients in Hilla City. J. biotechnol., 15(2), 377-381.
[42] Donders GG, Van Calsteren K, Bellen G, Reybrouck R, Van den Bosch T, Riphagen I & Van Lierde S
(2009). Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic
vaginitis during the first trimester of pregnancy. BJOG: An International Journal of Obstetrics &
Gynecology, 116(10), 1315-1324.
[43] Goldenberg RL, Andrews WW, Goepfert AR, Faye-Petersen O, Cliver SP, Carlo WA & Hauth, JC. (2008).
The Alabama Preterm Birth Study: umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis
cultures in very preterm newborn infants. American journal of obstetrics and gynecology, 198(1), 43-e1.
[44] Matovina M, Husnjak K, Milutin N, Ciglar S, and Grce M. (2004). Possible role of bacterial and viral
infections in miscarriages. Fertility and sterility, 81(3), 662-669.
[45] Armitage CW, Carey AJ, Hickey DK & Beagley KW. (2018). Chlamydia Trachomatis Urogenital Infections: Epidemiology, Clinical Presentations, and Pathogenesis. Diagnostics to Pathogenomics of Sexually Transmitted Infections, 135.
[46] Prasad P, Singh N, Das B, Raisuddin S, Dudeja M, & Rastogi S. (2017). Differential expression of circulating Th1/Th2/Th17 cytokines in serum of Chlamydia trachomatis-infected women undergoing incomplete spontaneous abortion. Microbial pathogenesis, 110, 152-158.
[47] Cassell GH. (1997). Risk Factors for Chorioamnion Infection and Adverse Pregnancy Outcome among Active-Duty Military Women and Dependent Women.
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