Molecular Detection of Ureaplasma urealyticum and Ureaplasma parvum Colonization in Preterm Infants with Respiratory Distress Syndrome

Abstract

RDS, a major cause of morbidity and mortality in preterm infants. Among the infectious agents that colonize or infect respiratory tract, Ureaplasma have been linked to the development of chronic lung disease (CLD), while their role in the pathogenesis of RDS when associated with prematurity remains controversial. These organisms can be detected in vaginal flora in 40%–80% of healthy women and their presence has been causally linked to infertility, early pregnancy loss, stillbirth, preterm birth and neonatal morbidities. Vertical transmission from mothers to their infants occurs in utero or during delivery. PCR techniques have proved useful in detecting Ureaplasma in clinical specimens due to time saving and the possibility of directly identifying the Ureaplasma species. This study was conducted on 35 preterm neonates who were admitted immediately or shortly after birth to NICU of El Matarriah Teaching Hospital within a period of time of 6 months. The aim of this study was to investigate the colonization of the respiratory tract of preterm newborns by U. urealyticum, U. parvum using PCR and trying to find a possible relation between RDS and Ureaplasma. According to the results of PCR, ureaplasma is detected in 6 (17%) cases. Among these 5 cases (83%) were U.P +ve with a mean gestational age of (32.33+2.42) weeks while 1 case (17%) was U.U +ve. Summary 127 U. parvum more than U. urealyticum were found by PCR in respiratory secretions of preterm newborns with RDS, indicating its role in the pathogenesis of RDS more than U. urealyticum. Regarding degree of respiratory distress and duration of ventilation, duration of hospitalization and grades of RDS by X- ray, ureaplasma positive group had higher chest x-ray scoring for RDS, sever degree of respiratory distress, longer duration of oxygen supplementation (with a mean 14.5+4.5 days -p<0.05), and hospital stay with a mean of (17.9+5.6 days -p<0.05) and a higher mortality rate (50%). These results documented evidence of RDS in neonates colonized with Ureapasma. U. parvum more than U. urealyticum were found by