The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to major developmental, abortive or fatal in outcome. Some bacteria are common and are part of the normal genital tract flora (Lactobacillus sp), while other bacterial infections are less common or even rare and initially infect/transmit by air or fluids through the different epithelia (genital tract, lungs, gastrointestinal tract).
Note that some infections may have historic or alternative common names, for example Pertussis "whooping cough".
Page Links: Introduction | Some Recent Findings | Gonorrhea | Listeria | Lyme Disease | Mycoplasma | Pertussis | Bacterial Meningitis | Syphilis | Staphylococcus aureus | Tuberculosis | Bacterial Vaginosis | Gram Stain | Australian NHMRC Recommendations | WWW Links | References | Glossary
Antibiotics during pregnancy "Macrolides or clindamycin during the second trimester of pregnancy to women at risk of preterm births can lower the risk, a new systematic review and meta-analysis by Canadian researchers indicates. But the study also found that giving metronidazole alone in the second trimester is linked with a greater risk of preterm birth in the high risk population. The study's authors, from the University of Montreal and Laval University, Quebec, say that delivery before 37 weeks' gestation complicates between 7% and 11% of all pregnancies, is the leading cause of perinatal morbidity and mortality, and is responsible for high healthcare costs (Journal of Obstetrics and Gynaecology of Canada 2007;29:35-44)." (text from BMJ 2007;334(7587):224)
Giuliani MM, Adu-Bobie J, Comanducci M, Arico B, Savino S, Santini L, Brunelli B, Bambini S, Biolchi A, Capecchi B, Cartocci E, Ciucchi L, Di Marcello F, Ferlicca F, Galli B, Luzzi E, Masignani V, Serruto D, Veggi D, Contorni M, Morandi M, Bartalesi A, Cinotti V, Mannucci D, Titta F, Ovidi E, Welsch JA, Granoff D, Rappuoli R, Pizza M. A universal vaccine for serogroup B meningococcus. Proc Natl Acad Sci U S A. 2006 Jul 6; [Epub ahead of print] "Meningitis and sepsis caused by serogroup B meningococcus are two severe diseases that still cause significant mortality. To date there is no universal vaccine that prevents these diseases. In this work, five antigens discovered by reverse vaccinology were expressed in a form suitable for large-scale manufacturing and formulated with adjuvants suitable for human use. The vaccine adjuvanted by aluminum hydroxide induced bactericidal antibodies in mice against 78% of a panel of 85 meningococcal strains representative of the global population diversity."
Colombo DF, Lew JL, Pedersen CA, Johnson JR, Fan-Havard P. Optimal timing of ampicillin administration to pregnant women for establishing bactericidal levels in the prophylaxis of Group B Streptococcus. Am J Obstet Gynecol. 2006 Feb;194(2):466-70. "Bactericidal levels of ampicillin in the cord blood are rapidly achieved within 30 minutes of administration of ampicillin to the mother. The increase in the ratio of cord to maternal serum ampicillin levels is directly related to time, suggesting a decrease in the clearance of ampicillin in the newborns as compared to the mothers. The cord blood ampicillin concentration exceeds the maternal concentration and both continue to be above the minimal bactericidal concentrations at 5.6 hours after administration."
The gram-negative bacterium Neisseria gonorrhoeae causes the disease Gonorrhea which is a sexually transmitted disease (STD). Maternal infection increases the risk of premature birth and ophthalmia neonatorum (infantile purulent conjunctivitis).
Neisseria Gonorrhea, arrowed within a cell (diplococci) and extracellular (pleomorphic) (Image CDC)
Nowicki S, Selvarangan R, Anderson G. Experimental transmission of Neisseria gonorrhoeae from pregnant rat to fetus. Infect Immun. 1999 Sep;67(9):4974-6. "...This study provides the first experimental model that may mimic the transmission of gonococcal infection from mother to the fetus during pregnancy."
Links: CDC (USA) Fact Sheet - Gonorrhea | NCBI Bookshelf Medical Microbiology - Neisseria gonorrhoeae |
The bacterium Listeria monocytogenes is the pathogenic form of the 7 listeria species. Infection is generally through ingestion of organisms in contaminated food.
Listeria monocytogenes bacteria (Image CDC)
Maternal symptoms may be mild, fetal effects can range from insignificant through to major abnormalities. Maternal treatment relates to potential developmental effects.
See also the listeriosis review article Doganay M., 2003.
Links: Guinea pig placenta Listeria model | NCBI Bookshelf Medical Microbiology - Listeria | NHMRC (Australia) - Prevention of Listeria (PDF)
The bacterium spirochete Borrelia Burgdorferi causes Lyme disease. Infection can be through the blood by tick bite.
Borrelia burgdorferi, spirochete (or “corkscrew-shaped” bacteria) (Image CDC)
Links: CDC (USA) - Lyme Disease
Mycoplasmas come in many different varieties, occur as part of the normal human flora, and lack a bacterial cell wall. Infection is generally through the female genital tract.
Mycoplasma in respiratory epithelium (M, mycoplasma; m, microvillus; C, cilia, EM Image CDC)
Links: NCBI Bookshelf Medical Microbiology - Mycoplasma | CDC Mycoplasmas: Sophisticated, Reemerging, and Burdened by Their Notoriety
The bacterium Treponema pallidum causes syphilis which is a sexually transmitted disease (STD). Infection can lead to congenital infection with abortion, prematurity, neonatal death or multiple system abnormalities. (More? Abnormal Development - Syphilis)
Treponema pallidum (scanning EM, Image CDC)
Links: CDC (USA) Fact Sheet - Syphilis | CDC (USA) Fact Sheet - STD and Pregnancy NCBI Bookshelf Medical Microbiology - Syphilis Search |
The gram-positive bacterium Mycobacterium tuberculosis causes the disease Tuberculosis (TB) usually initially infecting the lungs. The infection can cross the placenta to infect the fetus infecting many different systems (liver, bones, kidneys, spleen, gastrointestinal tract, skin, lymph nodes).
Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis disease used in some countries to prevent childhood tuberculous meningitis and miliary disease.
Mycobacterium Tuberculosis (scanning EM, Image CDC)
Links: CDC (USA) - Tuberculosis | CDC (USA) - Tuberculosis Vaccine | NHMRC (Australia) - BCG vaccine |
The bacterium Neisseria meningitidis or Haemophilus influenzae type B (Hib) can cause the disease bacterial meningitis.
Hib immunization for infants and children are generally recommended. Recently a universal vaccine for serogroup B meningococcus has been developed (See Some Recent Findings 2006 and meningococcal vaccine 2001)
|
|
Neisseria meningitidis |
Haemophilus influenzae |
Links: CDC (USA) - Meningococcal Disease | Medline Plus - Meningitis |
The bacterium Bordetella pertussis can cause the disease Pertussis (Whooping Cough) can lead to infant mortality. (More? Pertussis)
May 2005 - First Combination Vaccine Approved to Help Protect Adolescents Against Whooping Cough USA Food and Drug Administration has approved booster immunization against pertussis (whooping cough) in combination with tetanus and diphtheria for adolescents. Pertussis is a highly contagious bacterial disease. (FDA 03 May 2005)
Links: CDC (USA) - Pertussis | Medline Plus - Pertussis | Pertussis Vaccination: Use of Acellular Pertussis Vaccines Among Infants and Young Children Recommendations of the Advisory Committee on Immunization Practices (ACIP) |
Staphylococcus aureus a gram-positive bacterium commonly present (25% of healthy people and animals) on the skin and nasal surfaces, no vaccines are available. Strains of this bacteria can produce toxins related to food poisoning and be resistant to various antibiotics.
Staphylococcus aureus (scanning EM, Image CDC)
Methicillin-resistant Staphylococcus aureus (MRSA) bacteria are resistant to various antibiotics including Methicillin, there are other strains which are resistant to specific antibiotics (vancomycin).
About 2% of Staphylococcus aureus produce a toxin Panton-Valentine leucocidin (PVL) which can be fatal in neonates.
Links: CDC (USA) - Staphylococcus | CDC (USA) - emerging infectious diseases | Medline Plus - Staph aureus food poisoning | Medical Microbiology - Staphylococcus |
Bacterial vaginosis imbalance of the normal vaginal flora (more anaerobic bacteria and less normal gram-positive bacteria Lactobacillus sp). Maternal infection is associated with a variety of pregnancy abnormalities including preterm birth and poor perinatal outcome.
Lactobacillus (gram-positive rods among squamous epithelial cells and neutrophils in vaginal smear, Image CDC)
References: Guerra B, Ghi T, Quarta S, Morselli-Labate AM, Lazzarotto T, Pilu G, Rizzo N. Pregnancy outcome after early detection of bacterial vaginosis. Eur J Obstet Gynecol Reprod Biol. 2006 Sep-Oct;128(1-2):40-5. Epub 2006 Feb 3.
Bacterial staining procedure named after Hans Christian Gram (1853–1938). Generally divides bacteria into either:
Gram-positive bacteria purple crystal violet stain is trapped by layer of peptidoglycan (forms outer layer of the cell).
Gram-negative bacteria outer membrane prevents stain from reaching peptidoglycan layer in the periplasm, outer membrane then permeabilized and pink safranin counterstain is trapped by peptidoglycan layer.
Lactobacillus (gram-positive rods among squamous epithelial cells and neutrophils in vaginal smear, Image CDC)
Links: Medical Microbiology | American Society for Microbiology
The Australian NHMRC (1988) recommends neonates be assessed for follow-up care under the following conditions.
(see the NHMRC WWW Page)
CDC (USA)
Public Health Training Network Epidemiology and Prevention of Vaccine-Preventable Diseases (viewable Webcasts requires Media Player) |
Advisory Committee on Immunization Practices (ACIP) Recommendations
Royal College of Obstetricians and Gynaecologists (UK)
Infection and Pregnancy - study group recommendations (Jun 2001)
Links: Reviews | Articles | Online Textbooks | Search Textbooks | Search PubMed | Glossary
Donders GG. Management of genital infections in pregnant women. Curr Opin Infect Dis. 2006 Feb;19(1):55-61.
Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med. 2005 Oct;33(10 Suppl):S390-7.
Boggess KA. Pathophysiology of preterm birth: emerging concepts of maternal infection. Clin Perinatol. 2005 Sep;32(3):561-9.
Hirsch E, Wang H. The molecular pathophysiology of bacterially induced preterm labor: insights from the murine model. J Soc Gynecol Investig. 2005 Apr;12(3):145-55.
Berman SM. Maternal syphilis: pathophysiology and treatment. Bull World Health Organ. 2004 Jun;82(6):433-8.
Doganay M. Listeriosis: clinical presentation. FEMS Immunol Med Microbiol. 2003 Apr 1;35(3):173-5.
Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. N Engl J Med. 2000 May 18;342(20):1500-7.
Ross SM. Sexually transmitted diseases in pregnancy. Clin Obstet Gynaecol. 1982 Dec;9(3):565-92.
Guerra B, Ghi T, Quarta S, Morselli-Labate AM, Lazzarotto T, Pilu G, Rizzo N. Pregnancy outcome after early detection of bacterial vaginosis. Eur J Obstet Gynecol Reprod Biol. 2006 Sep-Oct;128(1-2):40-5. Epub 2006 Feb 3.
Giuliani MM, Adu-Bobie J, Comanducci M, Arico B, Savino S, Santini L, Brunelli B, Bambini S, Biolchi A, Capecchi B, Cartocci E, Ciucchi L, Di Marcello F, Ferlicca F, Galli B, Luzzi E, Masignani V, Serruto D, Veggi D, Contorni M, Morandi M, Bartalesi A, Cinotti V, Mannucci D, Titta F, Ovidi E, Welsch JA, Granoff D, Rappuoli R, Pizza M. A universal vaccine for serogroup B meningococcus. Proc Natl Acad Sci U S A. 2006 Jul 6; [Epub ahead of print]
Colombo DF, Lew JL, Pedersen CA, Johnson JR, Fan-Havard P. Optimal timing of ampicillin administration to pregnant women for establishing bactericidal levels in the prophylaxis of Group B Streptococcus. Am J Obstet Gynecol. 2006 Feb;194(2):466-70.
Bakardjiev AI, Stacy BA, Portnoy DA. Growth of Listeria monocytogenes in the guinea pig placenta and role of cell-to-cell spread in fetal infection. J Infect Dis. 2005 Jun 1;191(11):1889-97.
Goffinet F, Maillard F, Mihoubi N, Kayem G, Papiernik E, Cabrol D, Paul G. Bacterial vaginosis: prevalence and predictive value for premature delivery and neonatal infection in women with preterm labour and intact membranes. Eur J Obstet Gynecol Reprod Biol. 2003 Jun 10;108(2):146-51.
Morley SL, Cole MJ, Ison CA, Camaraza MA, Sotolongo F, Anwar N, Cuevas I, Carbonero M, Campa HC, Sierra G, Levin M. Immunogenicity of a serogroup B meningococcal vaccine against multiple Neisseria meningitidis strains in infants. Pediatr Infect Dis J. 2001 Nov;20(11):1054-61.
Nowicki S, Selvarangan R, Anderson G. Experimental transmission of Neisseria gonorrhoeae from pregnant rat to fetus. Infect Immun. 1999 Sep;67(9):4974-6.
Search PubMed
Search Jan2006 "bacterial infection" 547,445 reference articles of which 45,020 were reviews.
Search PubMed: term = bacterial infection
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see also Normal Childhood Development
You should look at normal development of the effected systems in the embryo. Development Notes
Alternatively, go on to look at Systematic Development of organs and tissues.
For those wanting to see dynamic processes of development (and have a reasonably quick connection) then the Movies pages are good for watching changes occur.
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Maternal bacterial infections can impact on normal development and in some cases directly by crossing the placental barrier and infecting the developing embryo, or indirectly due to the impact on the mother, for example the effects of fever.
Information on this page is provided for Educational Purposes Only.
Often the developmental impact can be variable, depending on the time during development that the infection takes place, the "critical periods".
This page gives examples of a few known bacterial infections that can impact upon development (it is not a comprehensive list).
Information on this page is provided for Educational Purposes Only.
Please email Dr Mark Hill if you wish to make a comment about this current project.