Detection of Microorganisms in the Tracheal Aspirates of Preterm Infants by Polymerase Chain Reaction: Association of Adenovirus Infection with Bronchopulmonary Dysplasia

Abstract

Bronchopulmonary dysplasia (BPD) is recognized as an important cause of morbidity and mortality in preterm infants. Because the role of congenital infections in BPD has been debated, the purpose of this study was to test the hypothesis that detection of infectious agents in tracheal aspirate samples was associated with the development of BPD. Tracheal aspirate samples were obtained within the 1st week of life and screened by polymerase chain reaction for adenovirus, cytomegalovirus, parvovirus, enteroviruses, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma pneumoniae, and Chlamydia species. BPD was defined as persistent oxygen dependence at 28 d of age and 36 wk postconceptional age (PCA). Infants that expired before these time points were excluded from statistical analysis. Out of 89 infants studied, at 28 d of life, 13 had expired, 45 had BPD, and 31 had no BPD (controls). At 36 wk PCA, 15 infants expired, 39 still had BPD, and 35 did not. A significant increase in the frequency of adenovirus genome was identified in BPD patients compared with controls, both at 28 d of life (12/45 = 27% versus 1/31 = 3%: p< or =0.01) and at 36 wk PCA (10/39 = 29% versus 2/35 = 6%: p = 0.01). Other microorganisms were rarely detected and not associated with the development of BPD. This is the first study reporting the frequency of detection of adenovirus DNA in tracheal aspirate samples obtained during the 1st week of life from infants with BPD and suggests that prenatal acquisition may be important in the development of BPD.

Differential Vaginal Expression of Interleukin‐1 System Cytokines in the Presence of Mycoplasma hominis and Ureaplasma urealyticum in Pregnant Women

“…Tracheal aspirates of preterm infants are frequently colonized with U. urealyticum, without any apparent effect on the rate of bronchopulmonary dysplasia 19 or chronic lung disease 20 . In one study, the presence of U. urealyticum in tracheal aspirates was actually associated with a reduced rate of cystic periventricular leukomalacia 21 .…”

Genotype Prevalence and Risk Factors for Severe Clinical Adenovirus Infection, United States 2004-2006

“…Limited epidemiological investigations have revealed that, among some specific serotypes, multiple genetic variants exist that often have quite different geographical distributions and associated virulence [9][10][11]. In addition, largely because of molecular diagnostics, adenovirus infection has been associated with a number of acute and chronic diseases, including chronic airway obstruction [12] and pulmonary dysplasia [13], myocarditis and dilated cardiomyopathy [14], mononucleosis-like syndromes [15], intussusception [16], sudden infant perinatal death [17], and obesity [18,19]. Among some population groups, adenoviral infection is common and, often, severe.…”

Purulence and Gram-Negative Bacilli in Tracheal Aspirates of Mechanically Ventilated Very Low Birth Weight Infants

“…1,9 Serially obtained TC can lead to the diagnosis of bacterial or viral airway colonization, a subject that recently has attracted attention. 10,26,27 The presence of a newly acquired pathogen in tracheal and blood culture, together with pulmonary radiological signs, could assist in the diagnosis of VAP. 19 Our data show that at the time of the first purulent TA, the majority of mechanically ventilated VLBW infants were asymptomatic, and only 8 of 26 symptomatic infants had proven nosocomial infections (three BSI, five VAP).…”