Infection with Ureaplasma urealyticum and Mycoplasma hominis and the development of chronic lung disease in preterm infants

Abstract

In a prospective cohort study in a tertiary referral neonatal intensive care unit, the endotracheal secretions of 40 consecutively intubated newborn infants, less than 31 weeks' gestation, were examined weekly for the genital mycoplasmas and all other common bacterial pathogens. Fifteen (37%) infants were positive for Ureaplasma urealyticum and/or Mycoplasma hominis. There were no differences in gestation, birthweight, use of surfactant, or time on ventilator between the culture-positive and negative babies. Thirteen (87%) of the culture-positive group developed chronic lung disease (CLD) compared with 11 (41%) of the negative group (p = 0.0196). Of those culture-positive, 37% were not identified on the first specimen taken at the time of admission. These data suggest a significant association between infection with the urogenital mycoplasma and CLD and also stress the need for repeated cultures to identify these organisms.

Randomised trial of erythromycin on the development of chronic lung disease in preterm infants

“…The incidence of infection in the babies ⩽30 weeks of gestation was 15% compared with 25% found in the pilot study 5. The use of PCR as well as culture made it less likely that cases were missed, and this probably reflects the true incidence of infection in this unit.…”

“…Statistical comparisons at each time point were made using Mann-Whitney U tests. From the pilot studies in this unit5 6 it was calculated that a sample size of 80 babies would give 90% power to detect as significant a mean five-fold reduction in IL-8 concentrations resulting from treatment.…”

Chronic lung disease of prematurity. The role of intra-uterine infection

“…Others have also shown this relationship between Ureaplasma urealyticum and chronic lung disease [23] although not all studies have con®rmed the association. In some this may have been due to a reliance on nasopharyngeal rather than tracheal cultures.…”

Nuclear Factor κB Activation in Pulmonary Leukocytes from Infants with Hyaline Membrane Disease: Associations with Chorioamnionitis and Ureaplasma urealyticum Colonization

“…We focused on pulmonary inflammatory cells and related NF-B activation to TNF-␣ and IL-8 levels in tracheal aspirates from these infants. Perinatal factors that may contribute to lung inflammation include chorioamnionitis (21,22) and Ureaplasma urealyticum colonization/infection of the airway (23)(24)(25)(26)(27). We determined whether these conditions are also associated with evidence of NF-B activation in the infant lung.…”