{"title":"Clinical Characteristics and Current Treatment Modality of Preterm Infants with <i>Ureaplasma</i> spp. Infection.","authors":"Zhenhai Zhang, Jian Wang, Wenwen Chen, Liping Xu","doi":"10.3390/children11101202","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The impact of and countermeasures for <i>Ureaplasma</i> spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract <i>Ureaplasma</i> spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study.</p><p><strong>Methods: </strong>This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks.</p><p><strong>Results: </strong>The prevalence of respiratory tract <i>Ureaplasma</i> spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal <i>Ureaplasma</i> spp. colonization increased the risk of neonatal <i>Ureaplasma</i> spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with <i>Ureaplasma</i> spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, <i>p</i> = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, <i>p</i> < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, <i>p</i> < 0.001). Infants receiving anti-<i>Ureaplasma</i> spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA.</p><p><strong>Conclusions: </strong>GA and maternal vaginal <i>Ureaplasma</i> spp. colonization could be used to predict neonatal respiratory tract <i>Ureaplasma</i> spp. colonization. An elevated WBC count combined with normal CRP is a good marker of <i>Ureaplasma</i> spp. colonization/infection. It is conventional practice to start anti-<i>Ureaplasma</i> spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"11 10","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505890/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Children-Basel","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/children11101202","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
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Abstract
Background: The impact of and countermeasures for Ureaplasma spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract Ureaplasma spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study.
Methods: This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks.
Results: The prevalence of respiratory tract Ureaplasma spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal Ureaplasma spp. colonization increased the risk of neonatal Ureaplasma spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with Ureaplasma spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, p = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, p < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, p < 0.001). Infants receiving anti-Ureaplasma spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA.
Conclusions: GA and maternal vaginal Ureaplasma spp. colonization could be used to predict neonatal respiratory tract Ureaplasma spp. colonization. An elevated WBC count combined with normal CRP is a good marker of Ureaplasma spp. colonization/infection. It is conventional practice to start anti-Ureaplasma spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable.
期刊介绍：
Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries.
The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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