Ureaplasma and bronchopulmonary dysplasia.

Advances in neonatal intensive care have greatly improved survival rates for children born in a very early stage of lung development (i.e. less than 26 weeks of gestation). In these premature babies, even low levels of oxygen and methods of minimally invasive ventilation may disrupt the growth of the distal airways, a condition described as "new" bronchopulmonary dysplasia (BPD). Ureaplasma infection can occur in utero or in the perinatal period in premature infants, in some of which the infection with these organisms triggers an important lung pro-inflammatory and pro-fibrotic response, and may increase the risk of developing BPD. The inflammation may be worsened by exposure to oxygen and mechanical ventilation. At present, clinical studies have not clarified the role of Ureaplasma in the pathogenesis of BPD and there is insufficient evidence to determine whether antibiotic treatment of Ureaplasma has influence on the development of BPD and its comorbidities. Future research in the context of well-designed and controlled clinical trials of adequate statistical power should focus on how to determine whether the treatment of Ureaplasma decreases lung inflammation, reduces rates of BPD, and improves long-term neurodevelopment.

Congenital pneumonia with sepsis caused by intrauterine infection of Ureaplasma parvum in a term newborn: a first case report.

We present an autopsy case of intrauterine pneumonia in a term newborn in whom Ureaplasma parvum was confirmed by PCR examinations, including a novel diagnostic tool for detecting pathogens that caused neonatal infections using multiplex PCR. This is the first report of U. parvum being implicated in the pathogenesis of congenital pneumonia with sepsis in a term newborn.

Mycoplasmas and ureaplasmas as neonatal pathogens.

The genital mycoplasmas represent a complex and unique group of microorganisms that have been associated with a wide array of infectious diseases in adults and infants. The lack of conclusive knowledge regarding the pathogenic potential of Mycoplasma and Ureaplasma spp. in many conditions is due to a general unfamiliarity of physicians and microbiology laboratories with their fastidious growth requirements, leading to difficulty in their detection; their high prevalence in healthy persons; the poor design of research studies attempting to base association with disease on the mere presence of the organisms in the lower urogenital tract; the failure to consider multifactorial aspects of diseases; and considering these genital mycoplasmas only as a last resort. The situation is now changing because of a greater appreciation of the genital mycoplasmas as perinatal pathogens and improvements in laboratory detection, particularly with regard to the development of powerful molecular nucleic acid amplification tests. This review summarizes the epidemiology of genital mycoplasmas as causes of neonatal infections and premature birth; evidence linking ureaplasmas with bronchopulmonary dysplasia; recent changes in the taxonomy of the genus Ureaplasma; the neonatal host response to mycoplasma and ureaplasma infections; advances in laboratory detection, including molecular methods; and therapeutic considerations for treatment of systemic diseases.

Role of Ureaplasma urealyticum and Chlamydia trachomatis in lung disease in low birth weight infants.

Forty four ventilated premature infants from three Neonatal Intensive Care Units around Melbourne were evaluated prospectively for evidence of Ureaplasma urealyticum and Chlamydia trachomatis infection in the respiratory tract. No C. trachomatis was found and this probably reflects the low prevalence of genital carriage in antenatal patients in our population. Nine percent of babes were colonized at birth with Ureaplasma urealyticum and 5% acquired colonization. One child whose mother was bacteremic for ureaplasma, had evidence of persistent respiratory colonization and development of pneumonia at day 16 of life, supporting a role for this organism as a respiratory pathogen. Bronchopulmonary dysplasia (BPD) occurred in 39% of the infants. Ureaplasma carriage correlated significantly with BPD development, as 29% of infants with BPD were ureaplasma positive compared to 4% of those without development of BPD (p = 0.02).

Ureaplasma urealyticum cultured from brain tissue of preterm twins who died of intraventricular hemorrhage.

We present a case of premature twins, born at 24 weeks of gestation. Both infants died of intraventricular hemorrhage, aged 1 and 3 days, respectively. Ureaplasma urealyticum was isolated from brain tissue obtained at the autopsy of both infants. Our observations lend additional evidence of the role of U. urealyticum as a central nervous system pathogen in premature infants.