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Ureaplasma urealyticum (Uu) commonly inhabits the vaginal tract of pregnant women and is known to be transmitted to the fetus and newborn. Tissue invasiveness by this organism has been suspected on the basis of the association between its presence and PMN infiltration of placental membranes, fetal surfaces and umbilical cord. This on-going study provides data concerning incidence, duration of positive culture, and clinical course of newborn infants with respiratory distress (RD) whose respiratory tracts are inhabited by this organism. To date, 65 infants GA 24-42 weeks with RD requiring mechanical ventilation (MV) had tracheal aspirate (TA) collected for Uu. 13 infants (20%) were positive. 1 infant remained positive after completion of erythromycin therapy. 6 of 10 infants that grew Uu had 2 or more TA's. 3 of 10 that grew Uu expired. 4 of 7 survivors and 1 of 3 who expired developed chronic lung disease (CLD) as defined by the need for MV and/or O2 > 30 days. The 3 survivors who did not develop CLD required MV and/or supplemental O2 for 4-23 days. Uu is commonly found in the respiratory tracts of critically ill infants with RD and persists for weeks. Its pathogenicity and the clinical course of infants who have antimicrobial therapy directed specifically towards this organism remain to be determined.

Tracheal aspirates (TA) are obtained at birth and serially from neonates with respiratory distress that require mechanical ventilation (MV) for greater than 1 week. Cultures include aerobic bacteria and gram stain twice weekly, viruses (CMV, HSV, VS, Adeno, Entero) once a week and mycoplasma (M. Hominis, Ureaplasma Urealyticum) once during the first week of hospitalization and weekly thereafter if positive. The significance of grams stain and culture during the first 24 hours of life, the incidence and duration of bacterial and viral colonization/infection of the respiratory tract, the effect of systemic antibiotics on bacterial presence and the importance of mycoplasma infections are being investigated. Preliminary results from 209 bacterial, 102 viral, and 90 mycoplasmal cultures reveal: the most common bacterial organisms were coagulase negative Staphlococcus and Haemophilus strains. Once present, organisms persist for weeks. All cases (5) of congenital pneumonia had positive gram stains and/or culture during the first 24 hours. 68% of cultures obtained during the antibiotic therapy were negative. 1 infant grew HSV and 2 grew transfusion acquired CMV (1 survivor grew CMV for weeks). U. Urealyticum grew from 20% of infants (13/65). Most were GA 30 days) of the neonate is being evaluated.