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Optimum Detection of Ureaplasma in Premature Infants

M Colleen Brand1, George T Mandy1, Sushrut Arora2

  • 1From the Texas Children's Hospital Newborn Center, Baylor College of Medicine Pediatrics, Newborn Section.

The Pediatric Infectious Disease Journal
|April 11, 2018
PubMed

Insights

Early and late nasal and oral screening for Ureaplasma in premature infants is crucial. This approach optimizes detection of Ureaplasma spp., aiding timely antibiotic treatment to prevent bronchopulmonary dysplasia.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Pediatric Pulmonology

Background:

  • Ureaplasma spp. is a significant risk factor for bronchopulmonary dysplasia in premature infants.
  • Early-life antibiotic treatment (azithromycin/clarithromycin) shows promise in reducing BPD in Ureaplasma-positive infants.
  • Reliable, non-invasive screening is essential to identify infants who would benefit from early antibiotic intervention.

Purpose of the Study:

  • To identify the optimal screening site and time for Ureaplasma spp. detection in premature infants (24-34 weeks gestation).
  • To evaluate the diagnostic performance of different sample types and collection timings for Ureaplasma screening.

Main Methods:

  • Collection of oral, nasal, gastric, and tracheal cultures from premature infants within the first 10 days of life (DOLs).
  • Immediate incubation of cultures in 10B broth media.
  • Verification of culture results and species identification using Polymerase Chain Reaction (PCR).

Main Results:

  • Ureaplasma spp. incidence was 47.6% (80/168 infants).
  • Nasal cultures demonstrated higher sensitivity than oral cultures (P=0.008), but combined oral and nasal screening is superior.
  • Late-onset cultures (DOL 7-10) were more sensitive than early-onset (DOL 1-2), but early screening is vital to avoid missing cases.

Conclusions:

  • Optimal detection of Ureaplasma spp. in premature infants requires sampling from both nasal and oral sites.
  • Cultures should be obtained both early (DOL 1-2) and later (DOL 7-10) within the first 10 days of life.
  • This comprehensive screening strategy maximizes the identification of Ureaplasma-positive infants for potential therapeutic intervention.
Abstract

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