Role of Ureaplasma urealyticum in lung disease of prematurity
Role of Ureaplasma urealyticum in lung disease of prematurity
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DOI：
10.1136/fn.81.3.f162
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发表时间：
1999-11-01
影响因子：
4.4
通讯作者：
Gilbert, GL
中科院分区：
文献类型：
--
作者：
Hannaford, K;Todd, DA;Gilbert, GL
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 of pregnancy were cultured for U urealyticum and outcomes compared in infants with positive and negative cultures.Results-U urealyticum was isolated from aspirates of 39 of 143（27%）infants.呼吸窘迫综合征（RDS）的发生率显着低于殖民地，比非殖民地的婴儿（p=0.002）。多因素Logistic回归分析显示，在单胎婴儿中，脲原体定植是RDS的唯一独立（阴性）预测因子（OR 0.36; p=0.02）。胎龄（OR 0.46; p=0.006）和解脲脲原体分离（OR 3.0; p=0.05）是慢性肺疾病（CLD）的独立预测因子，根据胎龄36周时需要补充氧气的定义。多胎妊娠也是RDS和CLD.Conclusions-Colonisation或感染脲原体的一个主要的独立预测因子，显然可以保护早产儿免受RDS的发展（提示宫内感染）。然而，在单胎婴儿中，它倾向于发展CLD，与胎龄无关。出生后对受影响婴儿的治疗不太可能显著改善结局，需要在早产发生前识别和治疗宫内脲原体感染的妇女。
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 of gestation were cultured for U urealyticum and outcomes compared in infants with positive and negative cultures.Results-U urealyticum was isolated from aspirates of 39 of 143 (27%) infants. 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 colonisation 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 age. Multiple gestation was also a major independent predictor of RDS and CLD.Conclusions-Colonisation or infection with ureaplasma apparently protects premature infants against the development of RDS (suggesting intrauterine infection). However, in singleton infants, it predisposes to development of CLD, independently of gestational age. Treatment of affected infants after birth is unlikely to significantly improve the outcome and methods are required to identify and treat the women with intrauterine ureaplasmal infection, before preterm delivery occurs.