Placenta and products of conception

Although any organism may cause infection of the placenta, the most common organisms associated with this syndrome include S. aureus, beta hemolytic streptococci, Listeria monocytogenes and E. coli.

Neisseria gonorrhoeae is a possibility and occasionally Mycobacterium tuberculosis will be considered and requested.

Setup If tissue is received, aseptically macerate the tissue with the use of a tissue grinder.

Direct Examination

Prepare 2 smears: one for Gram stain and one to be held in reserve.

Culture

Media Incubation
Blood Agar (BA) CO2, 35°C x 48 hours
Chocolate Agar (CHOC) CO2, 35°C x 48 hours
Vancomycin-Colistin-Nystatin Agar (VCN) CO2, 35°C x 72 hours
MacConkey Agar (MAC) O2, 35°C x 48 hours

Interpretation Examine the plates after 24 and 48 hours incubation. VCN 24, 48 and 72 hours. All potential pathogens should be identified.
Reporting

Gram Stain

Report with quantitation the presence of pus cells and organisms.

Culture

Negative Report
“No significant growth” or “ No growth” and “No Neisseria gonorrhoeae isolated”.

Positive Report
Neisseria gonorrhoeae” isolated (do not quantitate), beta lactamase negative or positive. “Report has been copied to Medical Officer of Health”.

Quantitate and report all other significant isolates with appropriate susceptibility results.

Telephone all positive GC cultures to floor/ordering Physician.

For all positive GC cultures, a Communicable Disease Report is sent to the Medical Officer of Health and recorded in the significant isolates log book.

References Cumitech 17A, 1993. “Lab. Diagnosis of Female Genital Tract Infections, ASM Press.

Bailey & Scott’s Diagnostic Microbiology. Finegold & Baron; 7th. Ed., C.V. Mosby Co. p. 301.