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Mycoplasma hominis and Ureaplasma urealyticum in neonates with suspected infection
G B Valencia1, F Banzon, M Cummings
1Department of Pediatrics, Children's Medical Center, State University of New York, Health Science Center, Brooklyn.
Abstract:
The role of genital mycoplasmas in the pathogenesis of neonatal infection is incompletely understood. We performed nasopharyngeal, blood and cerebrospinal fluid (CSF) cultures for Mycoplasma hominis and Ureaplasma urealyticum in 69 neonates who underwent a diagnostic workup for suspected sepsis. The mean gestational age was 35.9 weeks (range, 25 to 42 weeks) with a mean birth weight of 2386 g (range, 652 to 4420 g). Twenty-seven infants (39.1%) had positive nasopharyngeal cultures; 6 were positive for M. hominis, 10 for U. urealyticum and 11 for both organisms. Seven (26%) of these 27 patients developed chronic lung disease compared with 2 (4.7%) infants in the non-colonized group. Nine infants had positive CSF cultures for M. hominis and one infant had a positive CSF culture for U. urealyticum. All blood cultures were sterile. One of the infants with a positive CSF culture for M. hominis had clinical evidence of systemic infection. All of the infants were treated with antibiotic agents that were not active against mycoplasmas. These data indicate that genital mycoplasmas can be found commonly in the CSF and nasopharynx of infants with suspected sepsis. Their etiologic role in the causation of infection and chronic lung disease, however, remains unclear.
Insights
Genital mycoplasmas like Mycoplasma hominis and Ureaplasma urealyticum are common in neonates with suspected sepsis. Their role in causing neonatal infection and chronic lung disease requires further investigation.
Area of Science:
- Neonatal Medicine
- Microbiology
- Infectious Diseases
Background:
- The role of genital mycoplasmas in neonatal infections is not well-established.
- Mycoplasma hominis and Ureaplasma urealyticum are common causes of genitourinary infections.
Purpose of the Study:
- To investigate the presence and potential role of genital mycoplasmas in neonates undergoing sepsis workup.
- To determine the association between genital mycoplasma colonization and chronic lung disease in neonates.
Main Methods:
- Nasopharyngeal, blood, and cerebrospinal fluid (CSF) cultures were performed for Mycoplasma hominis and Ureaplasma urealyticum in 69 neonates.
- Gestational age, birth weight, and clinical outcomes including chronic lung disease were recorded.
Main Results:
- Genital mycoplasmas were detected in the nasopharynx of 39.1% of neonates and in CSF of 10 infants.
- Neonates with positive nasopharyngeal cultures had a higher incidence of chronic lung disease (26%) compared to uncolonized infants (4.7%).
- One infant with M. hominis in CSF showed signs of systemic infection; blood cultures were negative.
Conclusions:
- Genital mycoplasmas are frequently found in the CSF and nasopharynx of neonates with suspected sepsis.
- The etiological significance of these organisms in neonatal infection and chronic lung disease remains uncertain.
- Current antibiotic treatments may not be effective against mycoplasma infections in neonates.