Search

Background: Chronic inflammatory processes contribute to the pathogenesis of bronchopulmonary dysplasia (BPD). We hypothesized colonisation with Ureaplasma urealyticum (Uu) as a possible reason for an increased risk of developing prolonged oxygen dependency > 28 days in very low birth weight (VLBW) infants., Patients and Methods: From January 1998 to November 1999 pharyngeal swabs were prospectively obtained and tested for Uu at birth and then weekly in VLBW infants. The following variables were compared between Uu-positive and Uu-negative infants: prenatal corticosteroids, maternal infections, mode of delivery, gestational age, birth weight, gender distribution, RDS, surfactant therapy, maximum inspiratory oxygen concentration during the first 24 and 48 hours, duration of oxygen supplementation beyond day 28, PDA, and weight differences during the first week of life., Results: Of a total of 74 infants, 17 were found to be Uu-positive. The latter group showed a lower mean gestational age (29; 25 - 37 vs. 28; 24 - 34 WOG; p = 0.02) and a longer duration of oxygen supplementation after day 28 (0; 0 - 121 vs. 5; 0 - 134 d; p = 0.02). All other variables did not differ significantly between both groups. Multivariate analyses identified the variables birth weight and colonisation with Uu as risk factors for a longer period of oxygen dependency after day 28 (p < 0.01; p = 0.05)., Conclusion: These data indicate a correlation between the colonisation with Uu and prolonged oxygen dependency > 28 days.

Tests for the possible presence of Ureaplasma urealyticum (U. u.), a type of Mycoplasma transmitted perinatally, were performed on 53 consecutive mature newborns and a group of 108 predominantly premature infants. Standard microbiological tests were performed on smears from throat, nose and ear, as well as from vagina or anus. U. u. was isolated from 15 of the 53 mature newborns (28%): none of the children was ill. In the premature group the microorganism was isolated from 13 of the 108 infants (12%). Isolation was the more frequent the smaller the birth weight and the shorter the gestational period. The carrier rate was 50% (6 of 12) in those with birth weights under 1,500 g and a gestational period of less than 29 weeks. In all 6 newborns under 1,500 g who carried U. u. bronchopulmonary dysplasia developed, but in only 2 of the 9 in whom U. u. was not isolated. Administration of erythromycin (20-45 mg/kg.d intravenously) improved the clinical course of 3 of the 5 affected with bronchopulmonary dysplasia. The results demonstrate that U. u. is of significance in perinatal medicine and should be considered especially in the treatment of premature infants requiring artificial ventilation.