Association of Positive Ureaplasma in Gastric Fluid with Clinical Features in Preterm Infants
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Purpose: The purpose of the present study was to determine the association of positive Ureaplasma urealyticum in gastric fluid with clinical features and outcomes in preterm infants. Methods: Gastric fluid from the preterm infants was first aspirated within 30 minutes and cultured within 24 hours after birth to check for U. urealyticum. Infants were divided into two groups on the basis of the presence/absence of U. urealyticum. Results: U. urealyticum in gastric fluid was identified in 17 of 91 (19%) preterm infants. Compared with the negative U. urealyticum group, there were significantly higher percentage of infants with gestational age ≤30 weeks (P=0.020), higher Apgar score at 1 minute and 5 minutes (P=0.017 and P=0.048, respectively), and higher rate of vaginal delivery (P=0.000) in the positive U. urealyticum group. Although the incidence rate of bronchopulmonary dysplasia between the two groups was not different, the frequency of bronchopulmonary dysplasia without previous respiratory distress syndrome was significantly higher in the positive group (11%) than that in the negative group (1%) (P=0.030). Conclusion: The detection of U. urealyticum in gastric fluid is more frequent in infants with gestational age ≤30 weeks. It can be helpful to predict the development of bronchopulmonary dysplasia without previous respiratory distress syndrome in preterm infants.
Abstract
Purpose: The purpose of the present study was to determine the association of positive Ureaplasma urealyticum in gastric fluid with clinical features and outcomes in preterm infants. Methods: Gastric fluid from the preterm infants was first aspirated within 30 minutes and cultured within 24 hours after birth to check for U. urealyticum. Infants were divided into two groups on the basis of the presence/absence of U. urealyticum. Results: U. urealyticum in gastric fluid was identified in 17 of 91 (19%) preterm infants. Compared with the negative U. urealyticum group, there were significantly higher percentage of infants with gestational age ≤30 weeks (P=0.020), higher Apgar score at 1 minute and 5 minutes (P=0.017 and P=0.048, respectively), and higher rate of vaginal delivery (P=0.000) in the positive U. urealyticum group. Although the incidence rate of bronchopulmonary dysplasia between the two groups was not different, the frequency of bronchopulmonary dysplasia without previous respiratory distress syndrome was significantly higher in the positive group (11%) than that in the negative group (1%) (P=0.030). Conclusion: The detection of U. urealyticum in gastric fluid is more frequent in infants with gestational age ≤30 weeks. It can be helpful to predict the development of bronchopulmonary dysplasia without previous respiratory distress syndrome in preterm infants.
참고문헌 (29)
- Cassell GH, "Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in newborns", Clin Microbiol Rev, 6, pp.69~87 (1993)
- Volgmann T, "Ureaplasma urealyticum-harmless commensal or underestimated enemy of human reproduction? A review", Arch Gynecol Obstet, 273, pp.133~139 (2005)
- Sanchez PJ, "Perinatal transmission of Ureaplasma urealyticum: current concepts based on review of the literature", Clin Infect Dis, 17(Suppl 1), pp.S107~S111 (1993)
- van Waarde WM, "Ureaplasma urealyticum colonization, prematurity and bronchopulmonary dysplasia", Eur Respir J, 10, pp.886~890 (1997)
- Embree JE, "Placental infection with Mycoplasma homonis and Ureaplasma urealyticum: clinical correlation", Obstet Gynecol, 56, pp.475~481 (1980)
- Kasper DC, "The bacterial load of Ureaplasma parvum in amniotic fluid is correlated with an increased intrauterine inflammatory response", Diagn Microbiol Infect Dis, 67, pp.117~121 (2010)
- Viscardi RM, "Ureaplasma species: role in diseases of prematurity", Clin Perinatol, 37, pp.393~409 (2010)
- Alfa MJ, "Transmission of Ureaplasma urealyticum from mothers to full and preterm infants", Pediatr Infect Dis J, 14, pp.341~345 (1995)
- Abele-Horn M, "Vaginal Ureaplasma urealyticum colonization: influence on pregnancy outcome and neonatal morbidity", Infection, 25, pp.286~291 (1997)
- Miralles R, "Relationship between antenatal inflammation and antenatal infection identified by detection of microbial genes by polymerase chain reaction", Pediatr Res, 57, pp.570~577 (2005)
- Kilic D, "Prevalence and treatment of Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in patients with nongonococcal urethritis", Jpn J Infect Dis, 57, pp.17~20 (2004)
- Jobe AH, "Bronchopulmonary dysplasia", Am J Respir Crit Care Med, 163, pp.1723~1729 (2001)
- "Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation", Pediatrics, 114, pp.297~316 (2004), American Academy of Pediatrics Subcommittee on Hyperbilirubinemia
- Viscardi RM, "Incidence of invasive ureaplasma in VLBW infants: relationship to severe intraventricular hemorrhage", J Perinatol, 28, pp.759~765 (2008)
- 윤진상, "출생 시 Ureaplasma urealyticum 집락이 조산아의 임상 양상에 미치는 영향", 대한신생아학회지, 16(1), pp.47~54 (2009), 대한신생아학회
- Son DW, "Significance of interleukin-6 and Ureaplasma urealyticum detected by polymerase chain reaction in the tracheal aspirates at birth for the development of chronic lung disease (CLD) of prematurity and the risk factors for the different types of CLD according to the preceding illnesses", J Korean Soc Neonatol, 11, pp.170~184 (2004)
- Jones V, "The use of molecular techniques for bacterial detection in the analysis of gastric aspirates collected from infants on the first day of life", Early Hum Dev, 86, pp.167~170 (2010)
- Ollikainen J, "Chronic lung disease of the newborn is not associated with Ureaplasma urealyticum", Pediatr Pulmonol, 32, pp.303~307 (2001)
- Oue S, "Association of gastric fluid microbes at birth with severe bronchopulmonary dysplasia", Arch Dis Child Fetal Neonatal Ed, 94, pp.F17~F22 (2009)
- Lyon AJ, "Randomised trial of erythromycin on the development of chronic lung disease in preterm infants", Arch Dis Child Fetal Neonatal Ed, 78, pp.F10~F14 (1998)
- Payne NR, "New prospective studies of the association of Ureaplasma urealyticum colonization and chronic lung disease", Clin Infect Dis, 17(Suppl 1), pp.S117~S121 (1993)
- Heggie AD, "Frequency and significance of isolation of Ureaplasma urealyticum and Mycoplasma hominis from cerebrospinal fluid and tracheal aspirate specimens from low birth weight infants", J Pediatr, 124, pp.956~961 (1994)
- Iles R, "Infection with Ureaplasma urealyticum and Mycoplasma hominis and the development of chronic lung disease in preterm infants", Acta Paediatr, 85, pp.482~484 (1996)
- Goldenberg RL, "Intrauterine infection and preterm delivery", N Engl J Med, 342, pp.1500~1507 (2000)
- Agarwal P, "Ureaplasma urealyticum and its association with chronic lung disease in Asian neonates", J Paediatr Child Health, 36, pp.487~490 (2000)
- Iwasaka T, "Genital mycoplasma colonization in neonatal girls", Acta Obstet Gynecol Scand, 65, pp.269~272 (1986)
- Waites KB, "Congenital and opportunistic infections: Ureaplasma species and Mycoplasma hominis", Semin Fetal Neonatal Med, 14, pp.190~199 (2009)
- Castro-Alcaraz S, "Patterns of colonization with Ureaplasma urealyticum during neonatal intensive care unit hospitalizations of very low birth weight infants and the development of chronic lung disease", Pediatrics, 110, pp.e45~ (2002)
- Waites KB, "Serum concentrations of erythromycin after intravenous infusion in preterm neonates treated for Ureaplasma urealyticum infection", Pediatr Infect Dis J, 13, pp.287~293 (1994)