[Ureaplasma urealyticum in tracheal aspirate of ventilated premature infants: report of 6 cases].

In the Netherlands, up till now no reports have appeared describing neonatal colonisation of mechanically ventilated preterm neonates with Ureaplasma urealyticum. The present, prospective study was designed to assess the incidence of U. ureaplasma infections in a group of preterm newborns with prolonged ventilatory support because of respiratory failure. In 1989 110 preterm newborns with hyaline membrane disease (HMD) were mechanically ventilated; 23 for more than 7 days because of pulmonary abnormalities. Six of them (26%) had positive cultures of endotracheal aspirate for U. urealyticum. Gestational age at birth ranged from 26 to 33 5/7 weeks, birth weight from 790 to 2545 gram. Other bacteria or viruses were not present. Although all patients with positive cultures for U. urealyticum were treated with erythromycin and U. urealyticum was eradicated, no clinical effect was seen. Five of the 6 patients (83%) with U. urealyticum developed bronchopulmonary dysplasia (BPD), 2 of them (33%) died. Of the 17 neonates without U. urealyticum 9 (53%) developed BPD, whereas one (6%) died. Differences were not significant (Chi 2 test/Fisher exact test). Also in the Netherlands U. urealyticum can be demonstrated in endotracheal aspirate of ventilated preterm newborns. The hypothesis, that early diagnosis and treatment of U. urealyticum in this group of patients might decrease the morbidity and mortality caused by HMD and BPD, needs further study.