Role of Ureaplasma urealyticum in lung disease of prematurity

Aim-To examine the role of Ureaplasma urealyticum colonisation or infection in neonatal lung disease. Methods-Endotracheal aspirates from ventilated infants less than 28 weeks o f gestation were cultured for U urealyticum and outcomes compared in infant s with positive and negative cultures. Results-U urealyticum was isolated from aspirates of 39 of 143 (27%) infant s. Respiratory distress syndrome (RDS) occurred significantly less often in colonised, than in non-colonised infants (p=0.002). Multivariate logistic regression analysis showed that in singleton infants, ureaplasma colonisati on was the only independent (negative) predictor of RDS (OR 0.36; p=0.02). Both gestational age (OR 0.46; p=0.006) and isolation of U urealyticum (OR 3.0; p=0.05) were independent predictors of chronic lung disease (CLD), as defined by requirement for supplemental oxygen at 36 weeks of gestational a ge. Multiple gestation was also a major independent predictor of RDS and CL D. Conclusions-Colonisation or infection with ureaplasma apparently protects p remature infants against the development of RDS (suggesting intrauterine in fection). However, in singleton infants, it predisposes to development of C LD, independently of gestational age. Treatment of affected infants after b irth is unlikely to significantly improve the outcome and methods are requi red to identify and treat the women with intrauterine ureaplasmal infection , before preterm delivery occurs.