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[Prospective study of neonatal genital mycoplasma colonization and infection]
F Bonnin1, J Petitjean, B Guillois
1Service de néonatologie, CHRU Clémenceau, Caen, France.
Insights
Genital mycoplasmas like Ureaplasma urealyticum colonize newborns frequently in the first days of life. However, this study found no conclusive evidence linking this colonization to neonatal pneumonia, sepsis, or meningitis.
Area of Science:
- Neonatal infectious diseases
- Microbiology
- Pediatric infectious diseases
Context:
- Genital mycoplasmas, including Mycoplasma hominis and Ureaplasma urealyticum, are potential pathogens in neonatal infections.
- Neonatal Care Units (NCUs) admit infants at risk for various infections, necessitating etiological investigations.
- Understanding the role of microbial colonization in early-onset neonatal disease is crucial for effective management.
Purpose:
- To investigate the role of genital mycoplasmas in neonatal diseases such as pneumonia, sepsis, and meningitis.
- To determine the prevalence of pharyngeal and tracheal colonization by Mycoplasma hominis and Ureaplasma urealyticum in neonates.
- To assess the association between genital mycoplasma colonization and specific neonatal clinical outcomes.
Summary:
- A prospective study cultured pharyngeal, tracheal, blood, and cerebrospinal fluid specimens from 100 neonates in the NCU.
- Ureaplasma urealyticum (Uu) was isolated from 21% of infants within the first five days of life, often asymptomatically.
- While Uu was detected in blood cultures and associated with probable infections, neonates were cured without specific therapy, and no clear link to severe neonatal diseases was established.
Impact:
- This study highlights the common occurrence of genital mycoplasma colonization in newborns.
- The findings suggest that genital mycoplasma colonization alone may not be a primary cause of severe neonatal infections.
- Further research is needed to elucidate the precise pathogenic mechanisms and clinical significance of genital mycoplasmas in neonates.
Abstract:
Genital mycoplasmas have been implicated in different neonatal diseases as pneumonia, sepsis and meningitis. This prospective study was conducted to specify their role in these diseases. POPULATION AND METHODS--A pharyngeal or tracheal swab specimen for mycoplasmas culture was obtained from 100 infants admitted consecutively to the Neonatal Care Unit (NCU) during the first 24 hours of life. Mycoplasma culture of blood and cerebrospinal fluid was also performed. Pharyngeal and/or tracheal specimens were collected again on days 5, 15 and 28 if the child was still in the NCU. Mycoplasma hominis (Mh) and Ureaplasma urealyticum (Uu) were identified by culture in a modified Hayflick's medium. RESULTS--Three-hundred and ten pharyngeal or tracheal swabs were obtained (100 on day 0, 89 on day 5, 72 on day 15 and 49 on day 28). Twenty-one infants had one or more positive swabs in the first five days of life (20 on day 0 and one on day 5); those forming the "Myco+" group and the others forming the "Myco-" group. Uu was isolated alone from 20 infants, associated with Mh from one. Both groups were similar for gestational age, birth weight, maternal fever during labor, prolonged rupture of the fetal membranes or chorioamnionitis and for the incidence of acute respiratory distress. There was a statistically significant difference for the route of delivery (chi 2 < 0.02). One blood culture (from 92 performed) was positive for Uu and another positive for Uu and Mh. Both children were cured without any specific mycoplasmacidal therapy. Three children had probable Uu infection and were also cured without specific therapy. CONCLUSIONS--A pharyngeal colonization with genital mycoplasmas is common in the first days of life (21%) but our data do not allow us to conclude that they are accountable for newborn infections.