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极低出生体重儿侵袭性脲原体感染的发生率:与重度脑室内出血的关系

Incidence of invasive ureaplasma in VLBW infants: relationship to severe intraventricular hemorrhage.

作者信息

Viscardi R M, Hashmi N, Gross G W, Sun C-C J, Rodriguez A, Fairchild K D

机构信息

Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

出版信息

J Perinatol. 2008 Nov;28(11):759-65. doi: 10.1038/jp.2008.98. Epub 2008 Jul 3.

Abstract

OBJECTIVE

As Ureaplasmas may be pathogens in preterm infants, this study was conducted to determine the incidence of invasive disease with Ureaplasma parvum and Ureaplasma urealyticum and the relationship with adverse outcomes in a prospective cohort of very low birth weight (VLBW) infants.

STUDY DESIGN

DNA was extracted from the cord or venous blood and cerebrospinal fluid (CSF) samples obtained from 313 VLBW infants. PCR was performed using primers for the mba gene to detect all 14 serovars and then repeated for all positive samples using species-specific primers.

RESULT

Ureaplasma species were detected in serum and/or CSF samples from 74 of 313 (23.6%) infants. U. parvum was the predominant species (70%). Presence of Ureaplasma was significantly associated with elevated interleukin-1beta in cord blood (odds ratio (OR) 2.6, 1.05 to 6.45, P=0.039). Ureaplasma serum-positive infants had a 2.3-fold increased risk of intraventicular hemorrhage > or =grade 3 (OR 2.50; 1.06 to 5.89, P=0.036).

CONCLUSION

Invasive Ureaplasma occurs commonly in VLBW infants and may increase the risk for severe intraventricular hemorrhage.

摘要

目的

由于脲原体可能是早产儿的病原体,本研究旨在确定极低出生体重(VLBW)婴儿前瞻性队列中微小脲原体和溶脲脲原体侵袭性疾病的发生率及其与不良结局的关系。

研究设计

从313例VLBW婴儿的脐带血、静脉血和脑脊液(CSF)样本中提取DNA。使用针对mba基因的引物进行PCR以检测所有14个血清型,然后对所有阳性样本使用种特异性引物重复检测。

结果

313例婴儿中有74例(23.6%)的血清和/或脑脊液样本中检测到脲原体。微小脲原体是主要菌种(70%)。脐带血中白细胞介素-1β升高与脲原体的存在显著相关(优势比(OR)2.6,1.05至6.45,P = 0.039)。血清脲原体阳性的婴儿发生≥3级脑室内出血的风险增加2.3倍(OR 2.50;1.06至5.89,P = 0.036)。

结论

侵袭性脲原体在VLBW婴儿中普遍存在,可能增加严重脑室内出血的风险。

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