Ureaplasma urealyticum and its association with chronic lung disease in Asian neonates

Objective: The aim of the present prospective cohort study was to evaluate the relationship between lower respiratory tract colonization with Ureaplas ma urealyticum and development of chronic lung disease (CLD) in a high-risk neonatal population. Methods: Prospective cohort study of preterm infants with a birthweight < 1 500 g needing mechanical ventilation within 24 h of birth in a tertiary car e neonatal unit. Endotracheal aspirates from these infants were cultured wi thin 24 h for U. urealyticum and the rate of colonization was determined. T he primary outcome measure was the incidence of CLD at 28 days of life. Results: Of the 41 infants studied, 10 (24%) infants were colonized with U. urealyticum. The colonization rate was higher in babies < 1000 g compared with babies weighing 1000-1500 g (P = 0.04). There was no significant diffe rence between the colonized and non-colonized groups with regard to the ant enatal use of steroids, maternal prolonged rupture of membranes, gestationa l age, birthweight, sex, respiratory distress syndrome, use of surfactant, patent ductus arteriosus and gastrooesophageal reflux. Of the 37 survivors, 20 (54%) developed CLD; eight infants (88.5%) in the colonized group devel oped CLD compared with 12 infants (42.8%) in the non-colonized group (P = 0 .01). Conclusions: Neonates colonized with U. urealyticum were twice as likely to have CLD than non-colonized babies (relative risk 2.01; 95% confidence int erval 1.27-3.37). These data suggest a significant association between colo nization with U. urealyticum and CLD in infants weighing < 1500 g.