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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels

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Endotracheal colonization at birth is associated with a pathogen-dependent pro- and antiinflammatory cytokine

Jozef De Dooy1, Margareta Ieven, Wim Stevens

  • 1Department of Pediatrics, Division of Neonatology, University of Antwerp, Faculty of Medicine, B-2610 Wilrijk. jd978722@planetinternet.be

Pediatric Research
|August 6, 2004
PubMed

Insights

Respiratory tract colonization in preterm infants triggers a dose-dependent cytokine and C-reactive protein (CRP) response. This inflammation is linked to both pathogens and commensal flora, highlighting infection risks in neonates.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Immunology

Background:

  • Perinatal respiratory tract colonization in ventilated preterm infants is common.
  • The relationship between respiratory colonization and inflammatory mediators like cytokines and C-reactive protein (CRP) is not fully understood.

Purpose of the Study:

  • To investigate the association between endotracheal colonization and airway cytokine profiles.
  • To examine the correlation between colonization and C-reactive protein (CRP) levels in umbilical cord blood.

Main Methods:

  • Prospective cohort study of 141 ventilated preterm infants.
  • Analysis of endotracheal aspirates for microbial colonization.
  • Measurement of airway cytokines (IL-1β, IL-6, IL-8, TNF-α, IL-10, IL-12p70) and umbilical cord blood CRP.

Main Results:

  • 26% of infants were colonized, with pathogens, commensals, and Mycoplasmataceae identified.
  • Colonized infants showed increased pro-inflammatory (IL-1β, IL-6, IL-8, TNF-α) and anti-inflammatory (IL-10) cytokines in a dose-dependent manner.
  • Gram-negative organism colonization elicited the strongest cytokine response. Commensal flora induced similar inflammatory responses as traditional pathogens. Umbilical cord blood CRP was elevated in colonized infants, particularly with Gram-negative organisms.

Conclusions:

  • Endotracheal microorganisms in ventilated preterm infants induce a pathogen-specific, dose-dependent airway cytokine response.
  • Systemic CRP levels are also associated with colonization, suggesting a link between respiratory microbes and neonatal inflammation.

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