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Ureaplasma urealyticum demonstrated by open lung biopsy in newborns with chronic lung disease
W F Walsh1, S Stanley, K P Lally
1Department of Pediatrics, Wilford Hall USAF Medical Center, Lackland AFB, TX 78236-5300.
Abstract:
Lung biopsy tissue from eight infants with chronic lung disease was evaluated for the presence of Ureaplasma urealyticum. Specimens from four infants grew the organism. Pleural fluid cultures matched lung tissue but tracheal cultures were negative in two babies with positive lung tissue. There were no distinguishing pathologic findings in the four culture-positive infants which could be used to identify them vs. the culture-negative infants. Three culture-positive infants improved clinically after therapy directed at Ureaplasma even though two remained culture-positive. Ureaplasma grows in lung tissue of infants with chronic lung disease, it does not demonstrate any specific standard pathologic findings and tissue cultures do not match endotracheal cultures.
Insights
Ureaplasma urealyticum was found in lung tissue of infants with chronic lung disease. Standard pathology did not identify infected infants, but some improved with targeted therapy.
Area of Science:
- Neonatal Medicine
- Microbiology
- Pediatric Pulmonology
Background:
- Chronic lung disease (CLD) is a significant concern in premature infants.
- The role of specific microorganisms like Ureaplasma urealyticum in CLD pathogenesis is under investigation.
Purpose of the Study:
- To investigate the presence and implications of Ureaplasma urealyticum in lung biopsies of infants with CLD.
- To correlate microbial findings with histopathological features and clinical outcomes.
Main Methods:
- Lung biopsy specimens from eight infants with CLD were cultured for Ureaplasma urealyticum.
- Pleural fluid and tracheal aspirate cultures were compared with lung tissue cultures.
- Histopathological examination of lung tissue was performed.
- Clinical progress of infants was monitored following Ureaplasma-directed therapy.
Main Results:
- Ureaplasma urealyticum was detected in lung tissue of four out of eight infants.
- Positive lung tissue cultures correlated with pleural fluid cultures but not always with tracheal cultures.
- No distinct pathological findings differentiated culture-positive from culture-negative infants.
- Three of the four culture-positive infants showed clinical improvement after antibiotic treatment, despite persistent positive cultures in two.
Conclusions:
- Ureaplasma urealyticum can colonize lung tissue in infants suffering from chronic lung disease.
- Histopathology does not provide specific markers for Ureaplasma infection in this context.
- Discordance between lung tissue and tracheal cultures highlights the importance of direct tissue sampling.
- Therapeutic interventions targeting Ureaplasma may lead to clinical improvement in some infants with CLD.