Bronchoalveolar inflammation following airway infection in preterm infantswith chronic lung disease

Chronic lung disease (CLD) of the newborn is associated with pulmonary infl ammation. However, the origin of this inflammation is not known. We evaluat ed the impact of airway infection on bronchoalveolar inflammation in mechan ically ventilated preterm infant at risk for CLD (n = 68). Mean and maximum concentrations of the inflammatory mediators (IM) interleukin-l and interl eukin-8 were assayed in the tracheobronchial aspirate fluid (TAF) of neonat es with perinatal airway infection (Ureaplasma urealyticum, or bacteria), p ostnatal nosocomial airway infection, or respiratory disease without airway infection from days 1-10 of postnatal age. Patients with CLD (n = 23;) exhibited increased levels of IM in TAF compare d to neonates without CLD. Within the three subgroups, concentrations of IM were increased in CLD patients with perinatal infection and in CLD patient s with respiratory disease without airway infection, but not in CLD patient s with nosocomial airway infection. Although airway colonization with Gramn egative bacteria was more frequently found in CLD patients within the first month of life, there were no differences between levels of IM in patients colonized with Gram-negative bacteria or coagulase-negative staphyloccoci. We conclude that perinatal infections with Ureaplasma urealyticum or bacter ia and respiratory disease without infection, but not nosocomial airway inf ection, contribute to the bronchopulmonary inflammatory response in neonate s with CLD. (C) 2001 Wiley-Liss. Inc.