Perinatal Exposure Is Associated With Increased Risk of Late Onset Sepsis and Imbalanced Inflammation in Preterm Infants and May Add to Lung Injury.

Controversy remains concerning the impact of on preterm neonatal morbidity. Prospective single-center study in very low birth weight infants <30 weeks' gestation. Cord blood and initial nasopharyngeal swabs were screened for and using culture technique and polymerase chain reaction. Neonatal outcomes were followed until death or discharge. Multi-analyte immunoassay provided cord blood levels of inflammatory markers. Using multivariate regression analyses, perinatal exposure was evaluated as risk factor for the development of bronchopulmonary dysplasia (BPD), other neonatal morbidities until discharge and systemic inflammation at admission. 40/103 (39%) infants were positive for in one or both specimens, with being the predominant species. While exposure to alone was not associated with BPD, we found an increased risk of BPD in -positive infants ventilated ≥5 days (OR 1.64; 95% CI 0.12-22.98; = 0.009). Presence of was associated with a 7-fold risk of late onset sepsis (LOS) (95% CI 1.80-27.39; = 0.014). Moreover, -positive infants had higher I/T ratios ( 0.39; 95% CI 0.08-0.71; = 0.014), increased levels of interleukin (IL)-17 ( 0.16; 95% CI 0.02-0.30; = 0.025) and matrix metalloproteinase 8 ( 0.77; 95% CI 0.10-1.44; = 0.020), decreased levels of IL-10 ( -0.77; 95% CI -1.58 to -0.01; = 0.043) and increased ratios of Tumor necrosis factor-α, IL-8, and IL-17 to anti-inflammatory IL-10 ( = 03, = 0.012, < 0.001). Positive screening was not associated with BPD. However, exposure contributed to BPD in infants ventilated ≥5 days and conferred an increased risk of LOS and imbalanced inflammatory cytokine responses.