Role of Ureaplasma urealyticum and Chlamydia trachomatis in development of bronchopulmonary dysplasia in very low birth weight infants

Silva, O Da; Gregson, Daniel B.; Hammerberg, O.

doi:10.1097/00006454-199704000-00006

Cited by 52 publications

(21 citation statements)

References 30 publications

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“…Of five studies that followed serial cultures, four found an increased risk for BPD among Uu-colonized premature infants, but nasopharyngeal cultures were sometimes used in place of tracheal cultures to determine colonization (13,22,23,34,35). That 20% to 40% of patients may have positive PCRs for Uu with negative cultures also confounds efforts to correlate BPD with colonization by Uu (34,36). Our study demonstrates that approximately 50% of immature baboon infants may clear Uu from their pulmonary system within the first week after delivery.…”

Section: Discussionmentioning

confidence: 99%

Effects of Antenatal Colonization with Ureaplasma urealyticum on Pulmonary Disease in the Immature Baboon

et al. 2003

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Current nonhuman models for bronchopulmonary dysplasia have not included perinatal infection. We studied the effects of antenatal Ureaplasma urealyticum (Uu) infection in the 125-d immature baboon. Ten 125-d gestation (term ϭ 185 d) baboon dams were delivered after intra-amniotic inoculation with Uu. Serial blood and tracheal aspirate samples were analyzed for Uu colony-forming units, IL-6, IL-8, and cell counts. Physiologic parameters were serially recorded. Lung histology was examined after 14 d of ventilation and compared with unexposed controls. All Uu-exposed animals had Ͼ4 ϫ 10 2 CFU in tracheal aspirate at 24 h. Four of nine Uu animals remained heavily colonized [(ϩ) Uu] at necropsy (Ͼ6 ϫ 10 3 ). Five animals had negative or low tracheal colony-forming units. All Uu animals had significant increases for white blood cells, IL-6, and IL-8 in amniotic and fetal lung fluid. Compared with controls, (ϩ) Uu animals had significantly higher fraction of inspired oxygen, airway pressures, oxygenation index, and ventilation efficiency index between 48 and 240 h and had significantly elevated tracheal IL-6 and IL-8 concentrations between 72 and 240 h. Compared with controls (Ϫ) Uu animals had significantly better oxygenation index and ventilation efficiency index scores between 48 and 144 h. Lung histopathology in both Uu groups showed more severe bronchiolitis and interstitial pneumonitis compared with controls. Two patterns of disease were observed after Uu perinatal infection. Persistent colonization manifested a picture consistent with acute pneumonitis, worse lung function from 2 to 10 d, and prolonged elevated tracheal cytokines. Colonized animals that subsequently cleared Uu from the lung demonstrated early improved lung function compared with unexposed controls yet still manifested mixed bronchiolitis and interstitial pneumonitis at necropsy. Inherent immune system responses may determine outcome of perinatal Ureaplasma colonization. The pathogenesis of bronchopulmonary dysplasia (BPD) is incompletely understood, but pulmonary inflammation seems to play a critical key role (1-3). Pulmonary inflammation may be initiated by various insults, including hyperoxia, volutrauma, and infection. Recent reports suggest an important role for both postnatal and perinatal infection in the pathogenesis of BPD (4 -7).Evidence for microbial invasion of the amniotic cavity has been found in up to 80% of preterm births (8 ABSTRACT 797(Uu)(9 -11). The presence of Uu in the preterm respiratory tract has been correlated with elevated cellular and molecular markers of inflammation and associated with an increased risk for BPD (7,(12)(13)(14). Current nonhuman models for BPD are limited by the lack of perinatal infection as a confounding factor. A previous pilot study from this center demonstrated worse clinical and histologic hyaline membrane disease after Uu colonization of the 140-d preterm baboon (15). However, Ureaplasma colonization was conferred postnatally, and all animals were exposed to hyperoxia [fraction of inspired oxy...

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Section: Discussionmentioning

confidence: 99%

Effects of Antenatal Colonization with Ureaplasma urealyticum on Pulmonary Disease in the Immature Baboon

et al. 2003

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“…The studies were also grouped by definition of BPD, oxygen requirement at 28 days postnatal age (BPD28) and/or 36 weeks postmenstrual age (BPD36). Twenty-three articles reported Ureaplasma colonization and BPD28 (2,6,7,13,45,49,62,89,109,111,123,128,134,137,208,209,215,216,241,247,250,307,329) and eight reported BPD36 (49, 89, 109, 111, 127, 208, 209, 216). There were 2216 infants included in the BPD28 group and 751 infants in the BPD36 group.…”

Section: Association Of Ureaplasma Spp With Development Of Chronic Lmentioning

confidence: 99%

Mycoplasmas and Ureaplasmas as Neonatal Pathogens

Katz²,

2005

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SUMMARY The genital mycoplasmas represent a complex and unique group of microorganisms that have been associated with a wide array of infectious diseases in adults and infants. The lack of conclusive knowledge regarding the pathogenic potential of Mycoplasma and Ureaplasma spp. in many conditions is due to a general unfamiliarity of physicians and microbiology laboratories with their fastidious growth requirements, leading to difficulty in their detection; their high prevalence in healthy persons; the poor design of research studies attempting to base association with disease on the mere presence of the organisms in the lower urogenital tract; the failure to consider multifactorial aspects of diseases; and considering these genital mycoplasmas only as a last resort. The situation is now changing because of a greater appreciation of the genital mycoplasmas as perinatal pathogens and improvements in laboratory detection, particularly with regard to the development of powerful molecular nucleic acid amplification tests. This review summarizes the epidemiology of genital mycoplasmas as causes of neonatal infections and premature birth; evidence linking ureaplasmas with bronchopulmonary dysplasia; recent changes in the taxonomy of the genus Ureaplasma; the neonatal host response to mycoplasma and ureaplasma infections; advances in laboratory detection, including molecular methods; and therapeutic considerations for treatment of systemic diseases.

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“…This difference can reflect a lower infection rate among our study population or can be due to the low sensitivity of the culture method used. Indeed, we did not use the more sensitive polymerase chain reaction technique (31). Moreover, according to hospital policy, the majority of the mothers with preterm premature rupture of membranes are treated with azithromycin, an agent active against Ureaplasma spp.…”

Section: Mycoplasmataceaementioning

confidence: 99%

Endotracheal Colonization at Birth Is Associated with a Pathogen-Dependent Pro- and Antiinflammatory Cytokine Response in Ventilated Preterm Infants: A Prospective Cohort Study

et al. 2004

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Role of Ureaplasma urealyticum and Chlamydia trachomatis in development of bronchopulmonary dysplasia in very low birth weight infants

Abstract: C. trachomatis was found infrequently in the airways of premature very low birth weight infants. U. urealyticum was frequently detected but its presence was not significant with regard to development of BPD, duration of ventilatory support, oxygen dependency and length of hospital stay.

Cited by 52 publications

References 30 publications

Effects of Antenatal Colonization with Ureaplasma urealyticum on Pulmonary Disease in the Immature Baboon

Effects of Antenatal Colonization with Ureaplasma urealyticum on Pulmonary Disease in the Immature Baboon

Mycoplasmas and Ureaplasmas as Neonatal Pathogens

Endotracheal Colonization at Birth Is Associated with a Pathogen-Dependent Pro- and Antiinflammatory Cytokine Response in Ventilated Preterm Infants: A Prospective Cohort Study

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