Cassell G H, Waites K B, Crouse D T, Rudd P T, Canupp K C, Stagno S, Cutter G R
Department of Microbiology, University of Alabama, Birmingham School of Medicine.
Lancet. 1988 Jul 30;2(8605):240-5. doi: 10.1016/s0140-6736(88)92536-6.
Endotracheal aspirates from 200 infants who weighted less than or equal to 2500 g and who had evidence of respiratory disease were cultured within 24 h of birth for mycoplasmas, chlamydiae, viruses, and bacteria to evaluate the relation between lower respiratory tract infection and development of chronic lung disease and/or death. Ureaplasma urealyticum, an organism not visible on gram stain, not recovered on routine bacteriological media, and not susceptible to antibiotics commonly used to treat neonatal infections, was the single most common organism isolated. 14% of isolates were from infants born by caesarean section with intact membranes, which indicated that infection had occurred in utero. The findings probably represented true infection of the lower respiratory tract because the organism was recovered in pure culture in numbers greater than 10(3) from 85% of the infants, and also from the blood in 26% of infants. Those infants less than or equal to 1000 g with Ureaplasma urealyticum infection of the lower respiratory tract were twice more likely to have chronic lung disease or to die than were infants of similar birth-weight but who were uninfected, or infants greater than 1000 g. Very-low-birth-weight infants infected with ureaplasmas did not differ from those uninfected, either in demographic features or in potential risk factors for chronic lung disease.
对200名体重小于或等于2500克且有呼吸道疾病迹象的婴儿，在出生后24小时内采集气管内吸出物，培养其中的支原体、衣原体、病毒和细菌，以评估下呼吸道感染与慢性肺病和/或死亡发生之间的关系。解脲脲原体是分离出的最常见单一病原体，它在革兰氏染色中不可见，在常规细菌学培养基上无法生长，且对常用于治疗新生儿感染的抗生素不敏感。14%的分离株来自胎膜完整的剖宫产出生婴儿，这表明感染发生在子宫内。这些发现可能代表了下呼吸道的真正感染，因为在85%的婴儿中，该病原体以纯培养形式回收，数量超过10³，并且在26%的婴儿血液中也能检测到。与出生体重相似但未感染的婴儿或体重超过1000克的婴儿相比，体重小于或等于1000克且下呼吸道感染解脲脲原体的婴儿患慢性肺病或死亡的可能性高出两倍。感染脲原体的极低出生体重婴儿在人口统计学特征或慢性肺病潜在危险因素方面与未感染婴儿没有差异。
