Colonisation par Ureaplasma urealyticum et maladie pulmonaire chronique chez les nouveau-nés prématurés de moins de 32 semaines de gestation

Abstract

Colonization of the respiratory tract of premature newborn infants by genital mycoplasma is suspected to be associated with chronic lung disease. Methods and patients. – We prospectively determined the prevalence of genital mycoplasma colonization with nasopharyngeal or endotracheal culture in preterm neonates younger than 32 weeks gestation and its possible association with the development of chronic lung disease in a prospective study. Results. – Fifty-nine infants were enrolled and 11 (19%) were colonized with Ureaplasma urealyticum. In the subgroup of 45 ventilated infants, seven of seven U. urealyticum-positive infants developed chronic pulmonary disease versus ten of 38 (26%) of U. urealyticum-negative infants (relative risk [RR] = 3.8; 95% confidence interval [CI] 2.2 to 6.5, P < 0.001). U. urealyticum-colonized infants had a lower median birth weight (760 vs 1,083 g, P = 0.04), a lower gestational age (26 vs 28 weeks, P = 0.03), and a higher incidence of symptomatic patent ductus arteriosus (P = 0.03). These potential confounding factors may partially explain the association between U. urealyticum and chronic pulmonary disease. However, this association remained statistically significant when the analysis was restricted to infants with birth weight of 1,000 g or less (RR = 2.3; 95% CI 1.3 to 4, P = 0.02) or to infants with a patent ductus arteriosus (RR = 2; 95% CI 1.3 to 3.1, P = 0.02). Conclusion. – Colonization with U. urealyticum in ventilated preterm neonates younger than 32 weeks gestation is a significant risk factor of developing chronic pulmonary disease.