Agarwal P, Rajadurai V S, Pradeepkumar V K, Tan K W
Department of Neonatology, Kandang Kerbau Women's and Children's Hospital, Singapore.
J Paediatr Child Health. 2000 Oct;36(5):487-90. doi: 10.1046/j.1440-1754.2000.00557.x.
The aim of the present prospective cohort study was to evaluate the relationship between lower respiratory tract colonization with Ureaplasma urealyticum and development of chronic lung disease (CLD) in a high-risk neonatal population.
Prospective cohort study of preterm infants with a birthweight < 1,500 g needing mechanical ventilation within 24 h of birth in a tertiary care neonatal unit. Endotracheal aspirates from these infants were cultured within 24 h for U. urealyticum and the rate of colonization was determined. The primary outcome measure was the incidence of CLD at 28 days of life.
Of the 41 infants studied, 10 (24%) infants were colonized with U. urealyticum. The colonization rate was higher in babies < 1,000 g compared with babies weighing 1,000-1,500 g (P = 0.04). There was no significant difference between the colonized and non-colonized groups with regard to the antenatal use of steroids, maternal prolonged rupture of membranes, gestational age, birthweight, sex, respiratory distress syndrome, use of surfactant, patent ductus arteriosus and gastrooesophageal reflux. Of the 37 survivors, 20 (54%) developed CLD; eight infants (88.5%) in the colonized group developed CLD compared with 12 infants (42.8%) in the non-colonized group (P = 0.01).
Neonates colonized with U. urealyticum were twice as likely to have CLD than non-colonized babies (relative risk 2.01; 95% confidence interval 1.27-3.37). These data suggest a significant association between colonization with U. urealyticum and CLD in infants weighing < 1,500 g.
本前瞻性队列研究旨在评估解脲脲原体在下呼吸道定植与高危新生儿群体慢性肺病（CLD）发生之间的关系。
对一家三级护理新生儿病房中出生体重<1500g且在出生后24小时内需要机械通气的早产儿进行前瞻性队列研究。在这些婴儿出生后24小时内对气管内吸出物进行解脲脲原体培养，并确定定植率。主要结局指标是出生28天时CLD的发生率。
在研究的41名婴儿中，10名（24%）婴儿被解脲脲原体定植。体重<1000g的婴儿定植率高于体重1000 - 1500g的婴儿（P = 0.04）。在产前使用类固醇、母亲胎膜早破时间延长、胎龄、出生体重、性别、呼吸窘迫综合征、表面活性剂使用、动脉导管未闭和胃食管反流方面，定植组和未定植组之间没有显著差异。在37名存活者中，20名（54%）发生了CLD；定植组中有8名婴儿（88.5%）发生了CLD，未定植组中有12名婴儿（42.8%）发生了CLD（P = 0.01）。
被解脲脲原体定植的新生儿患CLD的可能性是非定植婴儿的两倍（相对风险2.01；95%置信区间1.27 - 3.37）。这些数据表明解脲脲原体定植与体重<1500g婴儿的CLD之间存在显著关联。
