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Ureaplasma urealyticum, erythromycin and respiratory morbidity in high-risk preterm neonates

B Jónsson1, M Rylander, G Faxelius

  • 1Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska Hospital and Institute, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|November 24, 1998
PubMed

Insights

Ureaplasma urealyticum colonization in preterm infants is linked to prematurity and delivery factors. Erythromycin reduced colonization but did not significantly impact oxygen needs.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Pediatric Respiratory Medicine

Background:

  • Ureaplasma urealyticum (Uu) colonization is a concern in very preterm infants.
  • Risk factors for Uu colonization and its impact on respiratory morbidity require further investigation.

Purpose of the Study:

  • To investigate Ureaplasma urealyticum colonization in infants under 30 weeks gestation.
  • To assess the relationship between Uu colonization and respiratory morbidity risk factors.
  • To evaluate the efficacy of erythromycin treatment for Uu colonization in this population.

Main Methods:

  • Cultured endotracheal aspirate and nasopharyngeal samples for Uu in 155 ventilated preterm infants (median GA 26 weeks).
  • Randomly assigned colonized infants to erythromycin treatment (40 mg/kg/d, IV or oral).
  • Assessed colonization rates, gestational age, delivery factors, and oxygen requirements at 36 weeks postconceptual age.

Main Results:

  • Uu colonization rate was 19% (29/155 infants).
  • Uu-colonized infants had lower gestational ages and higher rates of prolonged rupture of membranes, chorioamnionitis, and vaginal delivery.
  • Colonized infants required more supplemental oxygen at 36 weeks (p < 0.05).
  • Erythromycin effectively reduced Uu colonization (86% negative cultures).
  • No significant difference in supplemental oxygen duration between treated and untreated colonized infants.

Conclusions:

  • Ureaplasma urealyticum colonization is associated with increased prematurity, prolonged rupture of membranes, chorioamnionitis, and vaginal delivery.
  • Erythromycin treatment successfully reduces Uu colonization in preterm infants.
  • Erythromycin treatment did not significantly alter the duration of supplemental oxygen support.

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