Streptococcus agalactiae do not penetrate human chorioamniotic membranes in vitro but alter their biomechanical properties

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INTRODUCTION: Vaginal colonization with Streptococcus agalactiae (group B streptococci) is hypothesized to constitute a risk factor for Preterm Prelabor Rupture of Membranes. In vitro studies have shown that S. agalactiae strains isolated from infants with neonatal sepsis adhere to chorion cells of the human chorioamniotic membrane. However, it is still unknown if S. agalactiae strains penetrate the chorioamniotic membranes and whether S. agalactiae colonization affects the biomechanical properties of the membranes and thus, contribute to increased risk of Preterm Prelabor Rupture. The aim of this in vitro study was to explore if different strains of S. agalactiae penetrate and affect the biomechanical properties of human chorioamniotic membranes.

MATERIAL AND METHODS: Three different strains of S. agalactiae were obtained. One from an early-onset neonatal infection, one from a case of preterm prelabor rupture of membranes and one from a healthy pregnant carrier. Chorioamniotic membranes from elective cesarean deliveries were i) incubated with S. agalactiae or ii) mounted in a two-chamber incubation cell generating a "maternal" and a "fetal" chamber and incubated with S. agalactiae in the maternal chamber. Subsequently the membranes were examined to evaluate S. agalactiae attachment, penetration and the effect on the biomechanical properties.

RESULTS: At 5h after incubation, S. agalactiae adhered to the chorioamniotic membranes with increased number at 20h. S. agalactiae did not penetrate the membranes even after 20h of incubation. S. agalactiae increased the ultimate tensile stress needed to rupture the membranes and increased the work to rupture as well as the elastic modulus.

CONCLUSIONS: Human chorioamniotic membranes constitute a physical barrier against S. agalactiae infections. Moreover, S. agalactiae infection lead to increased strength of the membranes.

TidsskriftActa Obstetricia et Gynecologica Scandinavica
Sider (fra-til)1814-1821
Antal sider8
StatusUdgivet - okt. 2021

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