Role of Ureaplasma urealyticum and Chlamydia trachomatis in lung disease in low birth weight infants

doi:10.1080/00313029600169134

Pathology

Volume 28, Issue 3, 1996, Pages 266-269

https://doi.org/10.1080/00313029600169134 Get rights and content

Summary

Forty four ventilated premature infants from three Neonatal Intensive Care Units around Melbourne were evaluated prospectively for evidence of Ureaplasma urealyticum and Chlamydia trachomatis infection in the respiratory tract. No C. trachomatis was found and this probably reflects the low prevalence of genital carriage in antenatal patients in our population. Nine percent of babes were colonized at birth with Ureaplasma urealyticum and 5% acquired colonization. One child whose mother was bacteremic for ureaplasma, had evidence of persistent respiratory colonization and development of pneumonia at day 16 of life, supporting a role for this organism as a respiratory pathogen. Bronchopulmonary dysplasia (BPD) occurred in 39% of the infants. Ureaplasma carriage correlated significantly with BPD development, as 29% of infants with BPD were ureaplasma positive compared to 4% of those without development of BPD (p = 0.02).

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Cited by (38)

Ureaplasma and BPD
2013, Seminars in Perinatology
Citation Excerpt :
However, the contribution of Ureaplasma or chorioamnionitis to BPD is less clear. Several single center studies reported the association of Ureaplasma in the respiratory secretions of newborns with the development of BPD.54–58 Some studies used the BPD definition of oxygen supplementation at 28 days, while others used the more current definition of BPD as the need for oxygen supplementation at 36 weeks post-menstrual age.
Ureaplasma is an organism with low virulence and is a commensal of the lower genito-urinary tract in females. From here, it can gain entry in the amniotic fluid to cause inflammation in the amniotic compartment during pregnancy. Ureaplasma spp. are the most common organisms isolated from women with chorioamnionitis. Ureaplasma spp. are associated with increased risk for preterm labor and morbidity in the preterm neonate. However, there is some controversy regarding the importance of Ureaplasma in the pathogenesis of bronchopulmonary dysplasia (BPD). This article will review the microbiology of Ureaplasma, host innate immune responses, and the pathology of lung injury in animal models of Ureaplasma chorioamnionitis. We will review epidemiological studies of Ureaplasma and BPD in preterm infants and efficacy of antibiotics in preventing preterm labor and BPD.
Prenatal and Postnatal Microbial Colonization and Respiratory Outcome in Preterm Infants
2012, The Newborn Lung: Neonatology Questions and Controversies Expert Consult
Prenatal and Postnatal Microbial Colonization and Respiratory Outcome in Preterm Infants
2012, The Newborn Lung
Mycoplasmal infections
2010, Infectious Diseases of the Fetus and Newborn: Expert Consult - Online and Print
The bacterial load of Ureaplasma parvum in amniotic fluid is correlated with an increased intrauterine inflammatory response
2010, Diagnostic Microbiology and Infectious Disease
Citation Excerpt :
However, there are still controversial results from different studies investigating the role of Ureaplasma spp. and clinical outcomes of preterm infants. It seems that infection with these organisms triggers a vigorous proinflammatory response in the lungs facilitating development of BPD (Abele-Horn et al., 1998; Cassell et al., 1988; Colaizy et al., 2007; Garland and Bowman 1996), but this association remains controversial (Da Silva et al., 1997; Heggie et al., 2001; Ollikainen et al., 2001). In this context, the finding that a high percentage of sexually active women has vaginal colonization with Ureaplasma spp. (40–80%) (Waites et al., 2005) but normal term deliveries and that, correspondingly, many preterm infants are exposed to intrauterine Ureaplasma infection but have normal pulmonary and neurologic outcomes highlights the relevance of additional factors in the pathogenicity of these clinical entities, possibly including different Ureaplasma serovars and different bacterial loads.
Ureaplasma spp. are the most frequently isolated microorganisms inside the amniotic cavity and have been associated with spontaneous abortion, chorioamnionitis, premature rupture of the membranes (PROM), and preterm labor (PL). We analyzed 118 samples from amniotic fluid of preterm infants before 34 weeks of gestation by quantitative polymerase chain reaction (qPCR). Bacterial load, Ureaplasma biovar discrimination (Ureaplasma urealyticum and Ureaplasma parvum), and the level of inflammation were correlated with short-term clinical outcome. U. parvum was the predominant biovar, and increased bacterial load was significantly linked to histologic chorioamnionitis, PROM + PL, early-onset sepsis, and bronchopulmonary dysplasia. Furthermore, there was a positive correlation between the amount of U. parvum and the magnitude of inflammatory response inside the amniotic cavity observed by elevated interleukin 8 levels. We postulate that the bacterial load of Ureaplasma spp. measured by qPCR should be determined in studies investigating the potential clinical impact of intrauterine Ureaplasma spp. on the outcome of preterm infants.
Mycoplasmal Infections
2010, Infectious Diseases of the Fetus and Newborn Infant

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Pathology

Summary

References (27)

Vaginal colonization with Mycoplasma hominis and Ureaplasma urealyticum

Sex Transm Dis

The genital mycoplasmas

Perinatal mycoplasmal infections

Clinics in perinatology

Vertical transmission of Ureaplasma urealyticum from mothers to preterm infants

Pediatr Infect Dis J

Ureaplasmal pneumonia and sepsis associated with persistent pulmonary hypertension of the newborn

Pediatrics

Neonatal meningitis caused by Ureaplasma urealyticum

Pediatr Infect Dis J

Role of Ureaplasma urealyticum and other pathogens in the development of chronic lung disease of prematurity

Pediatr Infect Dis J

Chlamydial infection in women

Obstet Gynecol Clin North Am

Chlamydial infections in infancy

Review Article Aust Paediatr J

Chlamydial pneumonia in the low birthweight neonate

Arch Dis Child

Chronic respiratory disease in premature infants caused by Chlamydia trachomatis

J Clin Pathol

Bronchopulmonary dysplasia

Am Rev Respir Dis

Comparison of concentration and avidity of specific antibodies to E

coliin breast milk and serum. Immunology

Cited by (38)

Ureaplasma and BPD

Prenatal and Postnatal Microbial Colonization and Respiratory Outcome in Preterm Infants

Prenatal and Postnatal Microbial Colonization and Respiratory Outcome in Preterm Infants

Mycoplasmal infections

The bacterial load of Ureaplasma parvum in amniotic fluid is correlated with an increased intrauterine inflammatory response

Mycoplasmal Infections