Abstract
The study objective was to determine whether Ureaplasma respiratory tract colonization of preterm infants <33 wk gestation is associated with an increased risk for necrotizing enterocolitis (NEC). One or more tracheal or nasopharyngeal aspirates for Ureaplasma culture and PCR were obtained during the first week of life from 368 infants <33 wk gestation enrolled from 1999 to 2003 or from 2007 to 2009. NEC Bell stage ≥2 was confirmed by radiological criteria, and pathology, if available. Cord serum samples were analyzed for IL-6 and IL-1β concentrations, and placentas were reviewed for histological chorioamnionitis in the first cohort. NEC was confirmed in 29 of 368 (7.9%) of the combined cohorts. The incidence of NEC was 2.2-fold higher in Ureaplasma-positive (12.3%) than Ureaplasma-negative (5.5%) infants <33 wk (OR, 2.43; 95% CI, 1.13–5.2; p = 0.023) and 3.3-fold higher in Ureaplasma-positive (14.6%) than Ureaplasma-negative (4.4%) infants ≤28 wk (OR, 3.67; 95% CI, 1.36–9.93; p = 0.01). Age of onset, hematologic parameters at onset, and NEC severity were similar between Ureaplasma-positive and negative infants. Cord serum IL-6 and IL-1β concentrations were significantly higher in Ureaplasma-positive than in Ureaplasma-negative NEC-affected infants. Ureaplasma may be a factor in NEC pathogenesis in preterm infants by contributing to intestinal mucosal injury and/or altering systemic or local immune responses.
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Abbreviations
- BPD:
-
bronchopulmonary dysplasia
- NEC:
-
necrotizing enterocolitis
- VLBW:
-
very LBW
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Acknowledgements
We thank Elise Janofsky and Mary Spence for their technical assistance and data abstraction, and Lynn Duffy, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, for technical assistance.
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Supported by grants HL71113, HL087166, and 5RO1A1072577 from the National Institutes of Health.
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Okogbule-Wonodi, A., Gross, G., Sun, CC. et al. Necrotizing Enterocolitis Is Associated With Ureaplasma Colonization in Preterm Infants. Pediatr Res 69, 442–447 (2011). https://doi.org/10.1203/PDR.0b013e3182111827
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DOI: https://doi.org/10.1203/PDR.0b013e3182111827
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