출생 시 Ureaplasma urealyticum 집락이 조산아의 임상 양상에 미치는 영향
Association between Ureaplasma urealyticum Colonization and Adverse Outcomes in Premature Infants
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose : Present evidences suggest that Ureaplasma urealyticum is a cause of pneumonia, septicemia, and bronchopulmonary dysplasia (BPD) in newborn infants, particularly those born prematurely. The purpose of this work was to examine the relationship between Ureaplasma urealyticum in the tracheal aspirates and adverse outcomes, such as BPD and early onset neonatal sepsis in premature infants. Methods : A polymerase chain reaction (PCR) was performed on tracheal aspirates collected within 24 hour after birth in 176 premature infants less than 35 weeks of gestation and admitted to the neonatal intensive care unit of Bundang CHA Hospital. Results : U. urealyticum was detected in 37 of 176 preterm infants (21.0%). Gestational age (29＋5±2＋5 wk vs. 30＋6±2＋5 wk, P=0.013) and birth weight (1.39±0.44 kg vs. 1.59±0.55 kg, P=0.037) were lower in the U. urealyticum-positive group compared to the control group. The incidence of early onset neonatal sepsis (16.2% vs. 6.5%, P=0.045) and BPD (45.9% vs. 29.5%, P=0.047) was higher in the U. urealyticum-positive group compared to the control group, but the severity of BPD was not different between two groups. However, multiple logistic regression analysis revealed that the presence of U. urealyticum was not independently related to the development of early onset neonatal sepsis and BPD. Conclusion : The results suggest that colonization of the lower respiratory tract by U. urealyticum might not be related to the development of neonatal sepsis and BPD directly in preterm infants.
Abstract
Purpose : Present evidences suggest that Ureaplasma urealyticum is a cause of pneumonia, septicemia, and bronchopulmonary dysplasia (BPD) in newborn infants, particularly those born prematurely. The purpose of this work was to examine the relationship between Ureaplasma urealyticum in the tracheal aspirates and adverse outcomes, such as BPD and early onset neonatal sepsis in premature infants. Methods : A polymerase chain reaction (PCR) was performed on tracheal aspirates collected within 24 hour after birth in 176 premature infants less than 35 weeks of gestation and admitted to the neonatal intensive care unit of Bundang CHA Hospital. Results : U. urealyticum was detected in 37 of 176 preterm infants (21.0%). Gestational age (29＋5±2＋5 wk vs. 30＋6±2＋5 wk, P=0.013) and birth weight (1.39±0.44 kg vs. 1.59±0.55 kg, P=0.037) were lower in the U. urealyticum-positive group compared to the control group. The incidence of early onset neonatal sepsis (16.2% vs. 6.5%, P=0.045) and BPD (45.9% vs. 29.5%, P=0.047) was higher in the U. urealyticum-positive group compared to the control group, but the severity of BPD was not different between two groups. However, multiple logistic regression analysis revealed that the presence of U. urealyticum was not independently related to the development of early onset neonatal sepsis and BPD. Conclusion : The results suggest that colonization of the lower respiratory tract by U. urealyticum might not be related to the development of neonatal sepsis and BPD directly in preterm infants.
참고문헌 (36)
- Pararas MV, "Preterm birth due to maternal infection: causative pathogens and modes of prevention", Eur J Clin Microbiol Infect Dis, 25, pp.562~569 (2006)
- Anagrius C, "Mycoplasma genitalium: prevalence, clinical significance, and transmission", Sex Transm Infect, 81, pp.458~462 (2005)
- Kataoka S, "Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy", J Clin Microbiol, 44, pp.51~55 (2006)
- Witt A, "Increased intrauterine frequency of Ureaplasma urealyticum in women with preterm labor and preterm premature rupture of the membranes and subsequent cesarean delivery", Am J Obstet Gynecol, 193, pp.1663~1669 (2005)
- Harada K, "Vaginal infection with Ureaplasma urealyticum accounts for preterm delivery via induction of inflammatory responses", Microbiol Immunol, 52, pp.297~304 (2008)
- Jelsema R, "Ureaplasma associated preterm birth: is there a clinical application?", Am J Obstet Gynecol, 195, pp.1493~1494 (2006)
- Sanchez PJ, "Vertical transmission of Ureaplasma urealyticum from mothers to preterm infants", Pediatr Infect Dis J, 9, pp.398~401 (1990)
- Waites KB, "Ureaplasmal pneumonia and sepsis associated with persistent pulmonary hypertension of the newborn", Pediatrics, 83, pp.79~85 (1989)
- Waites KB, "Systemic neonatal infection due to Ureaplasma urealyticum", Clin Infect Dis, 17(1), pp.131~135 (1993)
- Cassell GH, "Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in newborns", Clin Microbiol Rev, 6, pp.69~87 (1993)
- Veleminsky M, "Relationship of vaginal microflora to PROM, pPROM and the risk of early-onset neonatal sepsis", Neuro Endocrinol Lett, 29, pp.205~221 (2008)
- Abele-Horn M, "Vaginal Ureaplasma urealyticum colonization: influence on pregnancy outcome and neonatal morbidity", Infection, 25, pp.286~291 (1997)
- Schelonka RL, "Ureaplasma infection and neonatal lung disease", Semin Perinatol, 31, pp.2~9 (2007)
- Katz B, "Characterization of ureaplasmas isolated from preterm infants with and without bronchopulmonary dysplasia", J Clin Microbiol, 43, pp.4852~4854 (2005)
- Grattard F, "Epidemiologic and molecular investigations of genital mycoplasmas from women and neonates at delivery", Pediatr Infect Dis J, 14, pp.853~858 (1995)
- Schelonka RL, "Critical appraisal of the role of Ureaplasma in the development of bronchopulmonary dysplasia with metaanalytic techniques", Pediatr Infect Dis J, 24, pp.1033~1039 (2005)
- Ollikainen J, "Chronic lung disease of the newborn is not associated with Ureaplasma urealyticum", Pediatr Pulmonol, 32, pp.303~307 (2001)
- Schrag SJ, "Risk factors for invasive, early-onset Escherichia coli infections in the era of widespread intrapartum antibiotic use", Pediatrics, 118, pp.570~576 (2006)
- Oddie S, "Risk factors for early onset neonatal group B streptococcal sepsis: case-control study", BMJ, 325(7359), pp.308~ (2002)
- 이우령, "신생아 패혈증", Korean Journal of Pediatrics, 45(3), pp.1~294 (2002), 대한소아과학회
- Philip AG, "Early diagnosis of neonatal sepsis", Pediatrics, 65, pp.1036~1041 (1980)
- Jobe AH, "Bronchopulmonary dysplasia", Am J Respir Crit Care Med, 163, pp.1723~1729 (2001)
- Kirchner L, "Amnionitis with Ureaplasma urealyticum or other microbes leads to increased morbidity and prolonged hospitalization in very low birth weight infants", Eur J Obstet Gynecol Reprod Biol, 134, pp.44~50 (2007)
- Volgmann T, "Ureaplasma urealyticum-harmless commensal or underestimated enemy of human reproduction? A review", Arch Gynecol Obstet, 273, pp.133~139 (2005)
- Waites KB, "Mycoplasmas and ureaplasmas as neonatal pathogens", Clin Microbiol Rev, 18통권 : 7, pp.757~789 (2005)
- Colaizy TT, "Detection of ureaplasma DNA in endotracheal samples is associated with bronchopulmonary dysplasia after adjustment for multiple risk factors", Pediatr Res, 61, pp.578~583 (2007)
- Lim IS, "Clinical menifestations of ureaplasma urealyticum colonization in infants", Korean J Perinatol, 18, pp.37~44 (2007)
- Viscardi RM, "Lung pathology in premature infants with Ureaplasma urealyticum infection", Pediatr Dev Pathol, 5, pp.141~150 (2002)
- Abele-Horn M, "Association of Ureaplasma urealyticum biovars with clinical outcome for neonates, obstetric patients, and gynecological patients with pelvic inflammatory disease", J Clin Microbiol, 35, pp.1199~1202 (1997)
- Kramer BW, "Prenatal inflammation and lung development", Semin Fetal Neonatal Med, 14, pp.2~7 (2009)
- Goldenberg RL, "The Alabama Preterm Birth Study: intrauterine infection and placental histologic findings in preterm births of males and females less than 32 weeks", Am J Obstet Gynecol, 195, pp.1533~1537 (2006)
- Brus F, "Fatal ureaplasmal pneumonia and sepsis in a newborn infant", Eur J Pediatr, 150, pp.782~783 (1991)
- Patterson AM, "Ureaplasma urealyticum respiratory tract colonization is associated with an increase in interleukin 1-beta and tumor necrosis factor alpha relative to interleukin 6 in tracheal aspirates of preterm infants", Pediatr Infect Dis J, 17, pp.321~328 (1998)
- Glass JI, "The complete sequence of the mucosal pathogen Ureaplasma urealyticum", Nature, 407, pp.757~762 (2000)
- Mabanta CG, "Erythromycin for the prevention of chronic lung disease in intubated preterm infants at risk for, or colonized or infected with Ureaplasma urealyticum", Cochrane Database Syst Rev, pp.CD003744~ (2003)
- Pinna GS, "The significance of Ureaplasma urealyticum as a pathogenic agent in the paediatric population", Curr Opin Infect Dis, 19, pp.283~289 (2006)