Ureaplasma urealyticum colonization, prematurity and bronchopulmonary dysplasia

Abstract

The aim of the present study was to determine the association between the presence of Ureaplasma urealyticum in endotracheal aspirates and bronchopulmonary dysplasia (BPD). In addition, a review of similar studies from the English literature is presented. During the period February 1990 until March 1991, 108 mechanically-ventilated infants were included in a prospective study. Endotracheal aspirates were cultured for U. urealyticum. Birth weight, gestational age and development of BPD was recorded. Cultures were positive in 23 infants, resulting in a 21% colonization. The infants with positive cultures had a significantly lower gestational age (mean 28.9 vs 31.5 weeks; range 25-40 vs 25-42 weeks; p=0.0014). A positive U. urealyticum culture was not associated with a low birth weight (mean 1,390 vs 1,690 g; range 675-4,090 vs 700-3,600 g; p=0.0712). A positive U. urealyticum culture was significantly associated with BPD (p=0.0373). However, after correction for gestational age by logistic regression analysis, BPD failed to correlate with the presence of positive U. urealyticum cultures. A MEDLINE search of the English language literature was performed to identify all studies having the association of U. urealyticum colonization and BPD. Fourteen controlled studies were found. Five studies found no significant association between U. urealyticum colonization and BPD. In two studies, after correction for gestational age, the association between U. urealyticum colonization and BPD did not remain significant. In five studies with a significant association between U. urealyticum colonization and BPD, no correction for gestational age had taken place. In conclusion, U. urealyticum colonization is not associated with the development of bronchopulmonary dysplasia. U. urealyticum is often associated with gestational age and/or low birth weight; to investigate the association between U. urealyticum and bronchopulmonary dysplasia correction for both parameters should be made.

Perinatal Infections With Ureaplasma

“…[36][37][38][39] However, other studies showed there was no such association. 11,[40][41][42] A meta-analysis in 1995, pooled 13 studies and found a significant association between U. urealyticum and BPD. 43 Even with a more rigorous definition of BPD, a meta-analysis performed in 2005 found this association as well.…”

Association of Ureaplasma infection pattern and azithromycin treatment effect with bronchopulmonary dysplasia in Ureaplasma positive infants: a cohort study

“…The association between Ureaplasma and BPD was first discussed by Holtzman et al in 1989, who concluded that there was not enough evidence to prove the association [5]. Several studies also investigated the association between Ureaplasma and BPD, yielding conflicting findings [6][7][8][9]. Castro-Alcaraz and colleagues found the pattern of Ureaplasma colonization may be related to BPD, given that infants with persistent Ureaplasma had an increased risk of BPD [10].…”

Association between colonization of the respiratory tract with Ureaplasma species and bronchopulmonary dysplasia in newborns with extremely low gestational age: a retrospective study

“…Meta-analyses ( 12 , 13 ) reported higher odds for BPD development in infants colonized with Ureaplasma spp. Studies included in these meta-analyses used the original definition of BPD as oxygen dependence at 28 days of life ( 12 , 13 ).…”

“…Meta-analyses ( 12 , 13 ) reported higher odds for BPD development in infants colonized with Ureaplasma spp. Studies included in these meta-analyses used the original definition of BPD as oxygen dependence at 28 days of life ( 12 , 13 ). This definition has later been updated to reflect the increased survival of extremely premature infants that often need supplemental oxygen or respiratory support in the first weeks simply due to lung immaturity ( 14 ).…”