Detection of bacteria in placental tissues obtained from extremely low gestational age neonates

OBJECTIVE: The objective of the study was to quantify and identify aerobic and anaerobic bacteria as well as Mycoplasma and Ureaplasma in the chorionic parenchyma. STUDY DESIGN: A sample of the chorionic parenchyma from neonates delivered between 23-27 completed weeks was cultured and tested by polymerase chain reaction (PCR) methods using universal bacterial primers for the presence of bacteria and mycoplasmas. RESULTS: The culture positive rate was higher for vaginal deliveries (333/ 489; 68%) than for cesarean sections (363/876; 41%). Thirty percent of all culture-positive samples had only aerobic bacteria, 21% of the samples had only anaerobic bacteria, and 9% of the samples had only Mycoplasma/ Ureaplasma. The mean concentration of Mycoplasma/Ureaplasma (4.00 +/- 1.11 log(10) CFU/g) was significantly higher (P < .001) than the total count of either aerobes (3.24 +/- 1.12 log(10) CFU/g) or anaerobes (2.89 +/- 0.99 log(10) CFU/g). Staphylococcus sp. and Corynebacterium sp. as well as organisms associated with bacterial vaginosis were the most frequently recovered. A PCR product was not detected from either randomly selected or known culture-positive samples. CONCLUSION: Approximately half of second-trimester placentas harbor organisms within the chorionic plate. The chorion parenchyma appears to harbor constituents that prevent the identification of bacterial deoxyribonucleic acid by PCR methods.