New Prospective Studies of the Association of Ureaplasma urealyticum Colonization and Chronic Lung Disease

Payne, Nathaniel R.; Steinberg, Susan S.; Ackerman, Patricia; Chrenka, Blair; Sane, Shashikant M.; Anderson, Katy T.; Fangman, John

doi:10.1093/clinids/17.supplement_1.s117

Cited by 56 publications

(36 citation statements)

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“…This is in agreement with the percentage of colonization of U. urealyticum in neonatal respiratory specimens reported in other studies from 3 to 23% (Blanchard et al, 1993;van Waarde et al, 1997;Payne et al, 1993;Jonsson et al, 1994;Mohagheghi et al, 2013). Higher rates were reported by Nelson et al (1998) (2000) (55%) that could be explained by larger sample size, or testing multiple specimens from enrolled patients.…”

Section: Discussionsupporting

confidence: 90%

Detection and biovar discrimination of Ureaplasma urealyticum colonization in preterm neonates under ventilation and correlation with bronchopulmonary dysplasia

El-Khier¹,

Megahed²,

Shokier³

2014

Afr. J. Microbiol. Res.

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Despite numerous studies, controversy regarding the association between Ureaplasma urealyticum colonization of premature neonates and bronchopulmonary dysplasia (BPD) still exists. The aim of the present study was to determine the colonization rate of preterm ventilated neonates with the two U. urealyticum biovars, parvo and T960, and to assess the correlation between colonization and the development of BPD. A prospective study was done from February 2013 to January 2014 in neonatal intensive care unit (NICU) in Mansoura University Children Hospital (MUCH) and NICU of different specialized medical centers, with 100 ventilated premature neonates (< 34 weeks) in the first 24 h of life, where tracheal secretions were aspirated, transported and cultured on 10B broth and A7 agar media. Culture was positive in 10 out of 85 samples (11.8%) as compared to 15/85 (17.6%) samples obtained by PCR technique. PCR assay demonstrated that Parva biovar (biovar 1) was the predominant, found in 9 (60%) out of 15 Ureaplasma isolates, as compared to T960 biovar (biovar 2) in 6 (40%) isolates. None of the neonates were cocolonized with both biovars. There was a statistically significant difference in the mean gestational age and mean birth weight between neonates with positive Ureaplasma colonization and neonates without colonization. BPD was significantly higher among colonized neonates than non-colonized one, 12 (80%) of 15 colonized neonates developed BPD as compared to 21 (30%) of 70 non colonized neonates. BPD was found to be correlated to decreasing gestational age (r = -0.341, p=0.001), low birth weight (r = -0.328, p= 0.002), and Ureaplasma colonization (r = 0.391, p < 0.001). Logistic regression analysis revealed that Ureaplasma colonization was a more important predictor for development of BPD than decreasing gestational age. BPD rate was higher among neonates colonized with T960 biovar (biovar 2) than those colonized with parvo biovar (biovar 1) (83.3% vs. 77.7%) with statistical significant difference (p = 0.001). colonization of respiratory tract by U. urealyticum, particularly biovar 2 (T960 biovar) in premature ventilated neonates was related to the development of BPD. PCR is a sensitive and specific technique for detecting Ureaplasma and for distinguishing its biovars (Parvum and T960) directly from clinical samples.

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Section: Discussionsupporting

confidence: 90%

Detection and biovar discrimination of Ureaplasma urealyticum colonization in preterm neonates under ventilation and correlation with bronchopulmonary dysplasia

El-Khier¹,

Megahed²,

Shokier³

2014

Afr. J. Microbiol. Res.

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“…This correlates with previous clinical studies that independently link Ureaplasma with BPD (19 -22) and death (22) despite surfactant treatment (21), and more recent studies and reviews continue to support this link (23)(24)(25). These studies showed differences in the studied populations, entrance criteria, and study design.…”

Section: Discussionsupporting

confidence: 86%

Antibiotic Prophylaxis Improves Ureaplasma-Associated Lung Disease in Suckling Mice

et al. 2009

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Ureaplasma infection is associated with increased lung disease in high-risk neonates. Our goal was to determine the impact of antibiotic prophylaxis on Ureaplasma and oxygen-induced lung disease in newborn mice. In animal model development and prophylaxis experiments, pups were randomly assigned to either 0.8 or 0.21 inspired oxygen concentration [fraction of inspired oxygen (FiO 2 )] from 1 to 14 d of age and either Ureaplasma or 10 B media daily from 1 to 3 d. All pups were observed for growth and survival. Surviving pups had culture and PCR evaluated for blood, bronchoalveolar lavage, and lung, and lung weights, pathology, morphometry, histology, and immunohistochemistry were determined. In prophylaxis experiments, erythromycin, azithromycin, or normal saline was given for the first 3 d, and minimum inhibitory concentration and pharmacokinetics were determined. In model development, 0.8 FiO 2 and Ureaplasma infection survival and growth were significantly decreased and lung edema and inflammation were significantly increased. In prophylaxis experiments, we observed significantly improved survival and growth with azithromycin versus normal saline controls, whereas erythromycin was not significantly different from controls, and decreased inflammatory response with azithromycin versus normal saline and erythromycin. In a neonatal mouse model of Ureaplasma and oxygen-induced lung disease, appropriate antibiotic prophylaxis improves survival and morbidity and decreases lung inflammation. (Pediatr Res 66: 197-202, 2009)

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“…Although this work demonstrates a strong associ- (14) 0 (0) 14 (17) . in magnitude to that obtained in the univariate analysis.…”

Section: Discussionmentioning

confidence: 63%

Patterns of Colonization WithUreaplasma urealyticumDuring Neonatal Intensive Care Unit Hospitalizations of Very Low Birth Weight Infants and the Development of Chronic Lung Disease

et al. 2002

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ABSTRACT. Background. Ureaplasma urealyticum and its association with chronic lung disease (CLD) of prematurity has remained a controversial topic. To readdress this question, we performed a longitudinal study using culture and polymerase chain reaction to detect U urealyticum in the respiratory tract of very low birthweight infants throughout their neonatal intensive care unit hospitalizations.Methods. We screened 125 infants weighing <1500 g and/or <32 weeks' gestational age over a 12-month period, collecting endotracheal, nasopharyngeal, and throat specimens on days of age 1, 3, 7, and weekly thereafter. CLD was defined as dependency on supplemental oxygen at 28 days and at 36 weeks' postconceptional age.Results. Forty infants (32%) had 1 or more positive specimens by culture or polymerase chain reaction. We identified 3 patterns of U urealyticum colonization: persistently positive (n ‫؍‬ 18), early transient (n ‫؍‬ 14), and late acquisition (n ‫؍‬ 8). We compared the rates of CLD in each of the 3 colonized groups with the rate of CLD in the noncolonized group. We found a significantly higher rate of CLD at 28 days of age (odds ratio: 8.7; 95% confidence interval: 3.3, 23) and at 36 weeks' postconception (odds ratio: 38.5, 95% confidence interval: 4.0, 374) only for infants with persistently positive colonization.Conclusions. This study demonstrates that the risk of developing CLD varies with the pattern of U urealyticum colonization. Only the persistently positive colonization pattern, which accounted for 45% of the U urealyticumpositive infants, was associated with a significantly increased risk of development of CLD. Pediatrics 2002; 110(4). URL: http://www.pediatrics.org/cgi/content/full/ 110/4/e45; bronchopulmonary dysplasia, chronic lung disease, premature infant, polymerase chain reaction, Ureaplasma urealyticum, very low birth weight infant.

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New Prospective Studies of the Association of Ureaplasma urealyticum Colonization and Chronic Lung Disease

Cited by 56 publications

References 10 publications

Detection and biovar discrimination of Ureaplasma urealyticum colonization in preterm neonates under ventilation and correlation with bronchopulmonary dysplasia

Detection and biovar discrimination of Ureaplasma urealyticum colonization in preterm neonates under ventilation and correlation with bronchopulmonary dysplasia

Antibiotic Prophylaxis Improves Ureaplasma-Associated Lung Disease in Suckling Mice

Patterns of Colonization WithUreaplasma urealyticumDuring Neonatal Intensive Care Unit Hospitalizations of Very Low Birth Weight Infants and the Development of Chronic Lung Disease

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