266 The Association between Respiratory Tract Ureaplasma Urealyticum Colonization And Severe Retinopathy Of Prematurity In Preterm Infants <= 1250 g (original) (raw)
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Eye, 2012
Aim To evaluate the association between respiratory tract Ureaplasma urealyticum (Uu) colonization and development of retinopathy of prematurity (ROP) requiring treatment. Methods The infants with birthweight (BW) r1250 g born in a third-level neonatal intensive care unit between March 2009 and May 2010 were prospectively identified. Nasopharyngeal swabs for Uu colonization were taken in postnatal first 3 days. Culturepositive patients were reevaluated on the twelfth day by nasopharyngeal swabs for Uu. The primary outcome was to define whether there was an association between respiratory tract Uu colonization and severe ROP requiring treatment. Independent sample's t-test or Mann-Whitney U-test was used to compare continuous variables and Chi-square test or Fisher's exact test for categorical variables. Multivariate (backward) logistic regression analysis was performed to simultaneously measure the influence of the independent variables with ROP as the dependent variable. Results A total of 25 (12.1%) infants developed severe ROP requiring treatment among 206 infants who underwent ROP screening. Mean BW and gestational age of total cohort were 1013 ± 159 g and 27.9 ± 1.6 weeks, respectively. Multivariate analysis demonstrated that BW (OR: 0.64 (95% Cl 0.47-0.88); P ¼ 0.006), duration of mechanical ventilation (OR: 1.17 (95% Cl 1.06-1.28); P ¼ 0.001), premature rupture of membrane 418 h (OR: 3.83 (95% Cl 1.2-12.2); P ¼ 0.02), and Uu positivity in both cultures (OR: 5.02 (95% Cl 1.8-13.9); P ¼ 0.002) were independent risk factors for the development of severe ROP requiring treatment. Conclusions Respiratory tract colonization with Uu was independently associated with severe ROP requiring treatment.
Screening for Ureaplasma urealyticum infections in the neonate and the association with prematurity
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1986
has been implicated in gynaecological, obstetrical and neonatal pathology. Increased levels of C-reactive protein and total IgM concentrations in cord blood have often been used as a screening method for infectious disease in the fetus and the newborn. Analysis of the isolation rate of U. ureaJyticum in function of the concentrations of these two parameters in cord blood showed that U. urealyticum was significantly (P < 0.05) more frequently isolated when CRP was above normal in cord blood. No correlation between the IgM level in the newborn and the presence of U. urealytdcum could be established. A significant relationship was found (P < 0.01) between Ureaplasma isolation in the urine of mother and child on the one hand and gestational age on the other hand, which supports the hypothesis that U. urealyticum may play a role in preterm delivery. C-reactive protein; IgM; genital mycoplasmas: cord blood
Role of Ureaplasma urealyticum in lung disease of prematurity
Archives of Disease in Childhood - Fetal and Neonatal Edition, 1999
Methods-Endotracheal aspirates from ventilated infants less than 28 weeks of gestation were cultured for U urealyticum and outcomes compared in infants with positive and negative cultures. Results-U urealyticum was isolated from aspirates of 39 of 143 (27%) infants. Respiratory distress syndrome (RDS) occurred significantly less often in colonised, than in non-colonised infants (p=0.002). Multivariate logistic regression analysis showed that in singleton infants, ureaplasma colonisation was the only independent (negative) predictor of RDS (OR 0.36; p=0.02). Both gestational age (OR 0.46; p=0.006) and isolation of U urealyticum (OR 3.0; p=0.05) were independent predictors of chronic lung disease (CLD), as defined by requirement for supplemental oxygen at 36 weeks of gestational age. Multiple gestation was also a major independent predictor of RDS and CLD.
Clinical relevance of Ureaplasma urealyticum colonization in preterm infants
Acta Paediatrica, 2007
A cohort of 78 infants of gestational age less than 34 weeks was examined for Ureaplasma urealyticum colonization and neonatal morbidity. Ureaplasma urealyticum was cultured from nasopharyngeal, endotracheal and blood-culture samples. A child was considered as being colonized if any sample was positive. The children with perinatal U. urealyticum colonization (n ¼ 11; 14%) differed from those with no colonization (n ¼ 67) in two important aspects: (i) they had higher leucocyte counts on the first (18.6 vs 12.4 10 9 ) and the second (29.0 vs 15.4 10 9 ) days of life ( p ¼ 0:01, both days); and (ii) they more often needed high-frequency oscillatory ventilation (45% vs 13%, p ¼ 0:02). This study showed that U. urealyticum colonization is associated with signs of the host defence response together with symptoms of respiratory tract involvement suggesting the pathogenicity of U. urealyticum in premature infants. ٖLung disease, preterm infant, Ureaplasma urealyticum, white cell counts J Ollikainen,
BMC infectious diseases, 2006
Ureaplasma urealyticum and U. parvum have been associated with respiratory diseases in premature newborns, but their role in the pathogenesis of the respiratory distress syndrome (RDS) is unclear. The aim of this study was to detect, using molecular techniques, the role of Mycoplasma spp. and Ureaplasma spp. in respiratory secretion and blood specimens of preterm newborns with or without RDS and to evaluate the prevalence of perinatal U. urealyticum or U. parvum infection. The influence of chemotherapy on the clinical course was also evaluated. Tracheal aspirate or nasopharingeal fluid samples from 50 preterm babies with (24) or without RDS (26) were analysed for detection of U. urealyticum and U. parvum by culture identification assay and PCR. Sequencing analysis of amplicons allowed us to verify the specificity of methods. Clarithromycin (10 mg kg-1 twice a day) was administered in ureaplasma-positive patients who presented clinical signs of RDS. 15/24 neonates with RDS (p < 0....
The Indian journal of medical research, 2007
Ureaplasma urealyticum has been implicated in various neonatal morbidities in preterm infants. Its association with chronic lung disease (CLD) remains controversial. The aim of this prospective study was to investigate colonization of U. urealyticum in preterm infants (with gestational age <34 wk) and to evaluate the relationship between U. urealyticum colonization and neonatal morbidity including CLD. U. urealyticum was cultured from nasopharyngeal or endotracheal aspirates collected within 24 h of birth from infant <or=34 wk gestation weighing <1800 g admitted to a Neonatal Intensive Care Unit of a tertiary care hospital in north India, and PCR was performed on the DNA extracted from these samples. Twenty per cent of the study infants were colonized with U. urealyticum. The mean gestational age of the infants in the colonized group was less than that of non colonized infants (P<0.05). The peripheral total leukocyte counts and mortality rate were higher in infants with ...
Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in newborns
Clinical microbiology reviews, 1993
Ureaplasma urealyticum, a common commensal of the urogenital tract of sexually mature humans, is gaining recognition as an important opportunistic pathogen during pregnancy. While its etiologic significance in many aspects of adverse pregnancy remains controversial, recent evidence indicates that U. urealyticum in the absence of other organisms is a cause of chorioamnionitis. Furthermore, ureaplasmal infection of the chorioamnion is significantly associated with premature spontaneous labor and delivery. In at least some cases, it appears to be causal. Present evidence indicates that U. urealyticum is a cause of septicemia, meningitis, and pneumonia in newborn infants, particularly those born prematurely. There is strong but not definitive evidence that ureaplasmal infection of the lower respiratory tract can lead to development of chronic lung disease in very low-birth-weight infants. Although risk factors for colonization of the lower genitourinary tract have been identified, littl...
The Journal of Pediatrics, 1995
Objectives: We performed a metaanalysis to determine whether there is an association between Ureaplasma urealyticum and chronic lung disease of prematurity (CLD); most studies involved small sample sizes, and the reported lack of statistical significance could have been due to inadequate power. Methods: Articles were identified from the literature through a search of MEDLINE, Excerpta Medica, and Reference Update, with the search terms "Ureaplasma urealyticum," "CLD," and "bronchopulmonary dysplasia." The search was initially conducted in June 1994 and updated in March 1995. Abstracts were identified through a hand search of proceedings from two meetings for the years 1987 through 1994. Summary data on frequency of CI.D in U. urealyticum-colo' nized and uncolonized babies were independently determined by the three authors. Preterm and term neonates were included. Colonization required recovery of U. urealyticum from a respiratory or surface specimen. The presence of CLD at 28 or 30 days was determined.
Frontiers in Cellular and Infection Microbiology, 2019
Background: Controversy remains concerning the impact of Ureaplasma on preterm neonatal morbidity. Methods: Prospective single-center study in very low birth weight infants <30 weeks' gestation. Cord blood and initial nasopharyngeal swabs were screened for Ureaplasma parvum and U. urealyticum using culture technique and polymerase chain reaction. Neonatal outcomes were followed until death or discharge. Multi-analyte immunoassay provided cord blood levels of inflammatory markers. Using multivariate regression analyses, perinatal Ureaplasma exposure was evaluated as risk factor for the development of bronchopulmonary dysplasia (BPD), other neonatal morbidities until discharge and systemic inflammation at admission. Results: 40/103 (39%) infants were positive for Ureaplasma in one or both specimens, with U. parvum being the predominant species. While exposure to Ureaplasma alone was not associated with BPD, we found an increased risk of BPD in Ureaplasma-positive infants ventilated ≥5 days (OR 1.64; 95% CI 0.12-22.98; p = 0.009). Presence of Ureaplasma was associated with a 7-fold risk of late onset sepsis (LOS) (95% CI 1.80-27.39; p = 0.014). Moreover, Ureaplasma-positive infants had higher I/T ratios (b 0.39; 95% CI 0.08-0.71; p = 0.014), increased levels of interleukin (IL)-17 (b 0.16; 95% CI 0.02-0.30; p = 0.025) and matrix metalloproteinase 8 (b 0.77; 95% CI 0.10-1.44; p = 0.020), decreased levels of IL-10 (b −0.77; 95% CI −1.58 to −0.01; p = 0.043) and increased ratios of Tumor necrosis factor-α, IL-8, and IL-17 to anti-inflammatory IL-10 (p = 0.003, p = 0.012, p < 0.001). Conclusions: Positive Ureaplasma screening was not associated with BPD. However, exposure contributed to BPD in infants ventilated ≥5 days and conferred an increased risk of LOS and imbalanced inflammatory cytokine responses.