Detection of Ureaplasma DNA in Endotracheal Samples Is Associated With Bronchopulmonary Dysplasia After Adjustment for Multiple Risk Factors

Microorganisms are hypothesized to contribute to the pathogenesis of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants. This hypothesis remains controversial. We sought to determine whether endotracheal colonization withUreaplasmasp., adenovirus, orChlamydiasp. increases the risk of BPD. Intubated VLBW infants were included. Polymerase chain reaction (PCR) analysis was used to detectUreaplasmasp., adenovirus, andChlamydiasp. The outcome measure was BPD or death due to lung disease. Detection of microorganisms was compared between subjects with and without BPD. Logistic regression was used to control for covariates. Of 139 subjects, 33 (25%) screened positive forUreaplasmasp., 22 of 136 (16%) were positive for adenovirus; eight of 133 (6%) were positive forChlamydiasp. At 36 wk postmenstrual age, 14 patients had died, 68 (57%) had BPD. Detection ofUreaplasma sp.was associated with BPD or death (p“ 0.001); adenovirus (p= 0.52) andChlamydia sp.(p= 0.33) were not. Controlling confounding factors, the odds ratio forUreaplasma sp.and BPD or death was 4.2 (95% CI 1.03, 17). In our population, detection ofUreaplasma sp.but not adenovirus orChlamydia sp.was associated with BPD or death due to lung disease. Abbreviations: BPDbronchopulmonary dysplasia EGAestimated gestational age PMApostmenstrual age VLBWvery low birth weight.