Waites K B, Crouse D T, Philips J B, Canupp K C, Cassell G H
Department of Microbiology, University of Alabama, School of Medicine, Birmingham 35294.
Pediatrics. 1989 Jan;83(1):79-85.
Ureaplasma urealyticum was isolated from the lower respiratory tract of three infants with persistent pulmonary hypertension of the newborn. In one, cultures positive for U urealyticum were obtained on multiple occasions from trachea, blood, and pleural fluid prior to the infant's death on postnatal day 6. Autopsy findings confirmed the presence of severe pneumonia and the organism was again recovered from multiple sites. A second infant had no apparent predisposing factors for development of persistent pulmonary hypertension of the newborn but U urealyticum and Staphylococcus epidermidis were recovered from the trachea antemortem and from lung tissue obtained during autopsy on the 12th postnatal day. The third infant had persistent pulmonary hypertension of the newborn and a pulmonary infiltrate within hours after birth with tracheal cultures positive for both U urealyticum and Mycoplasma hominis. Erythromycin was given for ten days, and the infant gradually improved. Prolonged ventilation with supplemental oxygen was necessary, and chronic lung disease developed. This is the first report of neonatal ureaplasmal pneumonia with sepsis and persistent pulmonary hypertension of the newborn as well as the first time a microorganism other than streptococci has been specifically implicated in the pathogenesis of persistent pulmonary hypertension of the newborn. Respiratory infections with U urealyticum or other bacteria should be considered as possible causative or contributory factors in infants with persistent pulmonary hypertension of the newborn.
从三名患有新生儿持续性肺动脉高压的婴儿的下呼吸道中分离出解脲脲原体。其中一名婴儿在出生后第6天死亡前，多次从气管、血液和胸腔积液中获得解脲脲原体阳性培养物。尸检结果证实存在严重肺炎，且该病原体再次从多个部位检出。第二名婴儿没有明显的新生儿持续性肺动脉高压发病的易感因素，但在出生后第12天尸检时，生前从气管中以及从肺组织中分离出了解脲脲原体和表皮葡萄球菌。第三名婴儿患有新生儿持续性肺动脉高压，出生后数小时出现肺部浸润，气管培养物中解脲脲原体和人型支原体均呈阳性。给予红霉素治疗10天，婴儿逐渐好转。需要长时间使用补充氧气进行通气，且出现了慢性肺病。这是关于新生儿解脲脲原体肺炎合并败血症及新生儿持续性肺动脉高压的首次报告，也是首次明确除链球菌外的其他微生物与新生儿持续性肺动脉高压的发病机制有关。对于患有新生儿持续性肺动脉高压的婴儿，应考虑解脲脲原体或其他细菌引起的呼吸道感染可能是致病或促成因素。
