Leukocyte Counts and Colonization with Ureaplasma urealyticum in Preterm Neonates

Abstract

In this paper we review the literature, present previously unpublished case reports for a pair of twins, and provide data from two prospective cohort studies to determine whether nasopharyngeal and/or endotracheal colonization with Ureaplasma urealyticum in preterm neonates is associated with an elevated white blood cell (WBC) count. We observed an association between colonization of the respiratory tract and elevation in the WBC count caused by an increase in the number of mature and immature neutrophils. Such a response indicates that U. urealyticum is capable of eliciting an inflammatory reaction and may be a true pathogen in the neonate. If these increases in the WBC count are confirmed, the WBC count may be a useful marker in future trials of interventions directed at U. urealyticum.

Leukocytosis in very low birth weight neonates: associated clinical factors and neonatal outcomes

“…This is inconsistent with most other studies that have reported a longer hospitalization and a higher rate of bronchopulmonary dysplasia among infants with leukemoid reaction. 7,9,13,16 Most studies have attributed the increased risk of lung morbidity to ureaplasma infection/colonization and to inflammation. 13,16 In our series, seven infants in the EL group had ureaplasma in their endotracheal aspirates.…”

“…7,9,13,16 Most studies have attributed the increased risk of lung morbidity to ureaplasma infection/colonization and to inflammation. 13,16 In our series, seven infants in the EL group had ureaplasma in their endotracheal aspirates. This number is almost certainly an underestimate of the rate of ureaplasma colonization, as endotracheal aspirates were not routinely sent in all infants.…”

“…5,6,10 Acute infection, which could lead to rapid clinical deterioration and serious complications, is one potentially treatable condition among these etiologies. Antenatal steroid treatment has been suggested as a possible cause of leukocytosis in preterm infants in some studies; [11][12][13] however, other studies have refuted this association. 3,7,14,15 Leukocytosis is considered a reaction to or reflection of inflammatory processes under most circumstances; however, this needs verification in the neonatal population.…”

“…7,16 An association between fetal inflammatory response syndrome and neonatal morbidities, especially chronic lung disease has been reported in small case series and case-control studies. 2,7,13 However, its association with other neonatal morbidities is not known.…”

Intra-uterine experimental infection by Ureaplasma diversum induces TNF-α mediated womb inflammation in mice

“…In other mycoplasma species, such as U. urealyticum, was observed that the presence of bacteria in the respiratory tract of infants stimulates an increasing total number of white blood cells (Viscardi et al 2002). However, the observed leukocytosis is associated with low immunity (Tegtmeier et al 1999, Ohlsson et al 1993, Honma et al 2007). Von Chamier et al (2012) reported that intra-uterine experimental infection in mice with U. parvum was able to induce sepsis with severe fetal infl ammatory response.…”