ORIGINAL ARTICLES 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 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. Respi-ratory distress syndrome (RDS) occurred significantly less often in colonised, than in non-colonised infants (p=0.002). Multi-variate logistic regression analysis showed that in singleton infants, ureaplasma colo-nisation was the only independent (nega-tive) 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 pre-mature infants against the development of RDS (suggesting intrauterine infection). However, in singleton infants, it predis-poses to development of CLD, independ-ently of gestational age. Treatment of aVected 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