Detection of microorganisms in the tracheal aspirates of preterm infants by polymerase chain reaction: Association of adenovirus infection with bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is recognized as an important cause of mor bidity and mortality in preterm infants. Because the role of congenital inf ections in BPD has been debated, the purpose of this study was to test the hypothesis that detection of infectious agents in tracheal aspirate samples was associated with the development of BPD. Tracheal aspirate samples were obtained within the 1st week of life and screened by polymerase chain reac tion for adenovirus, cytomegalovirus, parvovirus, enteroviruses, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma pneumoniae, and Chlamydia spec ies. BPD was defined as persistent oxygen dependence at 28 d of age and 36 wk postconceptional age (PCA). Infants that expired before these time point s were excluded from statistical analysis. Out of 89 infants studied, at 28 d of life, 13 had expired, 45 had BPD, and 31 had no BPD (controls). At 36 wk PCA, 15 infants expired, 39 still had BPD, and 35 did not. A significan t increase in the frequency of adenovirus genome was identified in BPD pati ents compared with controls, both at 28 d of life (12/45 = 27% versus 1/31 = 3%: p less than or equal to 0.01) and at 36 wk PCA (10/39 = 29% versus 2/ 35 = 6%: p = 0.01). Other microorganisms were rarely detected and not assoc iated with the development of BPD. This is the first study reporting the fr equency of detection of adenovirus DNA in tracheal aspirate samples obtaine d during the 1st week of life from infants with BPD and suggests that prena tal acquisition may be important in the development of BPD.