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Respiratory tract colonization with mycoplasma species increases the severity of bronchopulmonary dysplasia
V Bhandari1, N Hussain, T Rosenkrantz
1Department of Pediatrics, University of Connecticut Health Center, Farmington, USA.
Abstract:
There is controversy regarding the role of mycoplasmas (MP) colonizing the neonatal respiratory tract in the development of bronchopulmonary dysplasia (BPD). To determine the association of respiratory MP colonization and BPD. Retrospective analysis of neonates (26-32 weeks of gestation) intubated for respiratory insufficiency. Tracheal aspirate cultures were obtained for MP if the lung disease was not improving by 7-10 days or there were radiographic changes suggestive of inflammation. Of 63 infants who had tracheal aspirates sent, 17 had positive MP cultures. We found no significant difference in the gestational ages (27.6 +/- 0.4 vs 27.8 +/- 0.2 weeks) or birth weights (1097 +/- 86 vs 997 +/- 42 grams) in MP positive vs negative infants. No differences were noted in antenatal or postnatal steroid use, gender, race, sepsis, RDS, PDA, air leaks, NEC, GER, days on positive pressure ventilation or days on oxygen. There were significantly (p = 0.04) more infants with severe BPD (defined as oxygen requirement at 36 weeks corrected post menstrual age) among MP positive (n = 14; 82%) versus MP negative (n = 25; 54%) infants. Presence of MP in the tracheal aspirates is associated with an increased likelihood of developing severe BPD.
Insights
Mycoplasma (MP) colonization in the neonatal respiratory tract is linked to a higher risk of severe bronchopulmonary dysplasia (BPD). This study found a significant association between MP presence and severe BPD outcomes in premature infants.
Area of Science:
- Neonatal Medicine
- Respiratory Medicine
- Microbiology
Background:
- Controversy exists regarding the role of mycoplasma (MP) colonization in neonatal respiratory tract infections.
- Bronchopulmonary dysplasia (BPD) is a significant complication in premature infants requiring respiratory support.
Purpose of the Study:
- To investigate the association between respiratory mycoplasma colonization and the development of bronchopulmonary dysplasia (BPD) in preterm neonates.
- To determine if MP colonization increases the risk of severe BPD.
Main Methods:
- Retrospective analysis of 63 neonates (26-32 weeks gestation) requiring intubation for respiratory insufficiency.
- Tracheal aspirate cultures were analyzed for MP in infants with persistent lung disease or radiographic changes.
- Comparison of clinical characteristics and BPD severity between MP-positive and MP-negative infants.
Main Results:
- No significant differences in gestational age or birth weight were observed between MP-positive and MP-negative groups.
- No differences were found in antenatal/postnatal steroid use, gender, race, or common neonatal morbidities (sepsis, RDS, PDA, etc.).
- A significantly higher proportion of MP-positive infants (82%) developed severe BPD compared to MP-negative infants (54%) (p=0.04).
Conclusions:
- Presence of mycoplasma in tracheal aspirates is associated with an increased likelihood of developing severe bronchopulmonary dysplasia.
- MP colonization may be a contributing factor to the pathogenesis of severe BPD in vulnerable preterm infants.