Human miscarriage and infection in Tunisia: Role of Mycoplasma hominis and high Waddlia seroprevalence

Mariem Smaoui; Kebbi Carole; Hanen Sellami; Salma Kammoun; Khaled Choura; Leila Maazoun; Houssem Mestiri; Sebastien Aeby; Doulira Louati; Mohamed Derbel; Kais Chaabene; Adnene Hammami; Gilbert Greub; Abir Znazen

doi:10.3855/jidc.9829

Authors

Mariem Smaoui Laboratory of Microbiology, Research Laboratory “MPH”, Habib Bourguiba University Hopsital of Sfax, Sfax University, Sfax, Tunisia
Kebbi Carole Center for Research on Intracellular Bacteria (CRIB), Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne, Switzerland
Hanen Sellami Laboratory of Microbiology, Research Laboratory “MPH”, Habib Bourguiba University Hopsital of Sfax, Sfax University ,Sfax, Tunisia
Salma Kammoun Maternity Department, Hedi Chaker University hospital of Sfax, Sfax, Tunisia
Khaled Choura Maternity Department, Hedi Chaker University hospital of Sfax, Sfax, Tunisia
Leila Maazoun Family Planning Office, Sfax, Tunisia
Houssem Mestiri Maternity Department, Mahres Regional Hospital, Sfax, Tunisia
Sebastien Aeby Center for Research on Intracellular Bacteria (CRIB), Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne, Switzerland
Doulira Louati Maternity Department, Hedi Chaker University hospital of Sfax, Sfax, Tunisia
Mohamed Derbel Maternity Department, Hedi Chaker University hospital of Sfax, Sfax, Tunisia
Kais Chaabene Maternity Department, Hedi Chaker University hospital of Sfax, Sfax, Tunisia
Adnene Hammami Laboratory of Microbiology, Research Laboratory “MPH”, Habib Bourguiba University Hopsital of Sfax, Sfax University, Tunisia AND Laboratory of treatment and valorization of wastewater (CERTE). Borj-Cedria technopark, Tunisia.
Gilbert Greub Center for Research on Intracellular Bacteria (CRIB), Institute of Microbiology, University of Lausanne and University Hospital of Lausanne, Lausanne , Switzerland
Abir Znazen Laboratory of Microbiology, Research Laboratory “MPH”, Habib Bourguiba University Hopsital of Sfax, Sfax University ,Sfax, Tunisia

DOI:

https://doi.org/10.3855/jidc.9829

Keywords:

miscarriage, genital infection, zoonosis, genital mycoplasmas, Waddlia

Abstract

Introduction: Miscarriage is one of the most common adverse pregnancy outcomes. The aim of this study was to investigate the relationship between miscarriage in humans and infections caused by zoonotic bacteria and genital pathogens.

Methodology: Cervicovaginal swabs and placenta samples from 132 women with miscarriage (patient group: PG), and cervicovaginal swabs from 54 women with normal pregnancy (control group:CG), were subjected to bacteriological culture and real time PCRs detecting Coxiella burnetii, Brucella spp, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Waddlia chondrophila and Parachlamydia acanthamoebeae DNA. Serology of C. burnetii, C. trachomatis and W. chondrophila was also performed.

Results: Placenta samples were positive for E. coli, S. agalactiae, U. urealyticum, M. hominis and C. trachomatis in 4.7%, 3.1%, 3.1%, 0.7% and 0.7% of cases, respectively. For cervicovaginal swabs, M. hominis was more frequently detected among PG than CG with a significant statistical difference (p = 0.02). C. trachomatis was detected in 3.3% and 5.5% among PG and CG, respectively. U. urealyticum DNA was detected with high percentages in the two groups. Samples from both groups showed negatives results for C. burnetii, Waddlia, and Brucella qPCRs. A high rate of W. chondrophila seroprevalence (42%) was noted with significant difference among women with early miscarriage.

Conclusions: C. trachomatis, S. agalactiae and M. hominis may play a role in miscarriage. However, the full characterization of the vaginal flora using other technologies such as NGS-based metagenomics is needed to clarify their role in miscarriage. Finally, further investigations should be performed to explain high W. chondrophila seroprevalence.