Neonatal Ureaplasma urealyticum colonization increases pulmonary and cerebral morbidity despite treatment with macrolide antibiotics

• Published in: Infection Vol. 44; no. 3; pp. 323 - 327
• Main Authors: Resch, Bernhard, Gutmann, C., Reiterer, F., Luxner, J., Urlesberger, B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2016; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Bronchopulmonary Dysplasia - complications; Bronchopulmonary Dysplasia - epidemiology; Case-Control Studies; Colonization; Family Medicine; Female; General Practice; Humans; Infant, Newborn; Infant, Newborn, Diseases - drug therapy; Infant, Newborn, Diseases - epidemiology; Infant, Newborn, Diseases - microbiology; Infants; Infectious Diseases; Internal Medicine; Macrolides - therapeutic use; Male; Medicine; Medicine & Public Health; Morbidity; Original Paper; Respiratory Distress Syndrome, Newborn - complications; Respiratory Distress Syndrome, Newborn - epidemiology; Retrospective Studies; Treatment Outcome; Ureaplasma Infections - complications; Ureaplasma Infections - drug therapy; Ureaplasma Infections - epidemiology; Ureaplasma Infections - microbiology; Ureaplasma urealyticum; Ventilation; Bronchopulmonary dysplasia; Intraventricular hemorrhage; Erythromycin; Respiratory distress syndrome; Ureaplasma urealyticum
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-015-0858-7

Objective To evaluate the influence of Ureaplasma urealyticum (UU) colonization on neonatal pulmonary and cerebral morbidity. Methods Single-center case–control study including all preterm infants with positive UU tracheal colonization between 1990 and 2012. Cases were matched with controls by birth year, gestational age, birth weight, and sex. All cases had received macrolide antibiotics for UU infection starting at the time of first positive culture results from tracheal aspirates. Main outcome parameters included presence and severity of hyaline membrane disease (IRDS), duration of ventilation, bronchopulmonary dysplasia at 36 postmenstrual age and neurological morbidities (seizures, intra-/periventricular hemorrhages-I/PVH, periventricular leukomalacia-PVL). Results Of 74 cases identified 8 died and 4 had to be excluded; thus, 62 preterm infants were compared to 62 matched controls. UU was significantly associated with IRDS (79 vs. 61 %, p  = 0.015), BPD (24 vs. 6 %, p  = 0.003), seizures (23 vs. 5 %, p  = 0.002) and I/PVH (45 vs. 24 %, p  = 0.028). Cases had longer duration of mechanical ventilation and total duration of invasive and non-invasive ventilation (median 11 vs. 6 days p  = 0.006 and 25 vs. 16.5 days p  = 0.019, respectively). Conclusion UU was found to be significantly associated with pulmonary short- and long-term morbidity and mild cerebral impairment despite treatment with macrolide antibiotics.