Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis Respiratory Colonization in Malaysian Preterm Infants
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Published on: August 7, 2017
Khuen Foong Ng1, Kah Kee Tan2, Mi-Chelle Chok2
1Paediatric Infectious Diseases and Immunology, Great North Children's Hospital, NE1 4LP England; Department of Paediatrics, Tuanku Jaafar Hospital, 70300 Seremban, Malaysia.
Abstract:
This prospective observational study aims to determine the incidence, predictors and clinical features of Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) respiratory colonization in infants <37 weeks of gestation. A total of 200 preterm newborns admitted to a tertiary center in Malaysia between 2013 and 2015 for increased breathing effort had their respiratory secretions tested for these bacteria by polymerase chain reaction. Fifteen of the 200 (7.5%) infants were detected to have these organisms in their respiratory tracts. Preterm prelabor rupture of membrane was associated with positive detection (odds ratio: 3.7; 95% confidence interval: 1.2-11.3). Seventy-three of the 200 (36.5%) infants were given macrolide for presumed infection but only 4.1% (3 of 73) were positive for these organisms. The incidence of UU respiratory colonization among preterm infants in our center is lower than other published reports, while the frequency of MH and CT isolation is comparable with many studies. There should be judicious use of empirical antibiotics for presumed UU, MH and CT infection in preterm infants.
Insights
Respiratory colonization by Mycoplasma hominis, Ureaplasma urealyticum, and Chlamydia trachomatis is uncommon in preterm infants. Judicious antibiotic use is recommended, as empirical treatment is often unnecessary for these infections.
Area of Science:
- Neonatal Medicine
- Microbiology
- Pediatric Infectious Diseases
Background:
- Respiratory infections are a concern in preterm infants.
- Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Chlamydia trachomatis (CT) can cause respiratory issues.
- Data on the incidence of these specific pathogens in preterm infants is limited.
Purpose of the Study:
- To determine the incidence of MH, UU, and CT respiratory colonization in preterm infants (<37 weeks gestation).
- To identify predictors and clinical features associated with colonization.
- To evaluate the effectiveness of empirical macrolide treatment.
Main Methods:
- Prospective observational study of 200 preterm infants admitted for respiratory distress.
- Respiratory secretions analyzed for MH, UU, and CT using polymerase chain reaction (PCR).
- Association with preterm prelabor rupture of membranes (PPROM) analyzed.
Main Results:
- Overall incidence of MH, UU, or CT colonization was 7.5% (15/200).
- PPROM was a significant predictor (OR 3.7; 95% CI 1.2-11.3).
- Only 4.1% of infants receiving empirical macrolides were positive for these organisms.
Conclusions:
- The incidence of UU colonization is lower than reported elsewhere; MH and CT rates are comparable.
- Empirical antibiotic use for suspected UU, MH, or CT infections in preterm infants should be judicious.
- Further research into targeted antimicrobial therapy is warranted.
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