Bacterial infections in premature babies more common than previously realized

Jan 07, 2008

Premature babies are subject to a host of threats that can result in fetal/neonatal disease. In a study published in the January 2008 issue of the American Journal of Obstetrics & Gynecology, researchers from the University of Alabama–Birmingham Medical School and the Drexel University College of Medicine found that genital mycoplasmas are a frequent cause of congenital fetal infection. 23% of neonates born between 23 and 32 weeks of gestation have positive umbilical blood cultures for two genital mycoplasmas (bacteria lacking cell walls): Ureaplasma urealyticum and Mycoplasma hominis.

Although Ureaplasma urealyticum and Mycoplasma hominis are found in 80% of vaginal and cervical fluids, infants are not generally screened for these bacterial infections. The finding that about one-quarter of early preterm infants is already infected at birth is important in reducing adverse outcomes.

These newborns had a higher incidence of neonatal systemic inflammatory response syndrome (SIRS), higher incidence of bronchopulmonary dysplasia (BPD), higher serum concentrations of interleukin (IL)-6 and more evidence of placental inflammation than those with negative cultures. The earlier the gestational age at delivery, the higher the rate of a positive umbilical cord blood culture.

The data, derived from the Alabama Preterm Birth Study, included 457 consecutive singleton deliveries of infants born at 23-32 weeks’ gestation from 1996 to 2001. This study focuses on a subset of 351 women/infant pairs in the population who had umbilical cord blood cultures for U. urealyticum and M. hominis.

Writing in the article, Robert Goldenberg, M.D., Professor, Department of Obstetrics and Gynecology, Drexel University College of Medicine, states, “Given the frequency of these infections and their association with SIRS and likely with BPD, it seems reasonable to determine if infants in these categories would benefit from routine culture for Ureaplasma urealyticum and/or Mycoplasma hominis and subsequent treatment with an antibiotic effective against these organisms. Similarly, we question whether treatment of women likely to deliver an early gestational age infant with an antibiotic effective against these organisms might reduce subsequent neonatal morbidity and mortality.”’

In an accompanying editorial, Roberto Romero, MD, Chief of the Perinatology Research Branch and Program Director for Obstetrics and Perinatology at NICHD/NIH; Professor of Molecular Obstetrics and Genetics, Center of Molecular Medicine, Wayne State University, and Thomas J. Garite, MD, Professor Emeritus, Department of Obstetrics and Gynecology, University of California, Irvine, comment that the article “provides compelling evidence that congenital fetal infection is more frequent than previously realized. The detection of genital mycoplasmas is not part of routine clinical practice in obstetrics and neonatology. Similarly, standard treatment for suspected neonatal sepsis does not include antibiotics effective against these microorganisms.”

Romero and Garite further state that, “The initial uncertainties of whether genital mycoplasmas can cause fetal/neonatal disease are disappearing in light of the accumulating evidence that these microorganisms have been implicated in neonatal sepsis, pneumonia, meningitis and brain damage. Moreover, colonization of the neonatal respiratory tract with these organisms is a risk factor for chronic lung disease.”

Source: Elsevier

Explore further: Ebola death toll climbs to 2,630 out of 5,357 cases: WHO

add to favorites email to friend print save as pdf

Related Stories

Long lost Roman fort discovered in Gernsheim

10 minutes ago

In the course of an educational dig in Gernsheim in the Hessian Ried, archaeologists from Frankfurt University have discovered a long lost Roman fort: A troop unit made up out of approximately 500 soldiers ...

Carbon injection initiative supported by new research

30 minutes ago

Worldwide attempts to tackle global warming by injecting carbon dioxide into underground volcanic rock have been informed by new research that shows the process happens naturally on a massive scale over millions ...

Tandem microwave destroys hazmat, disinfects

30 minutes ago

Dangerous materials can be destroyed, bacteria spores can be disinfected, and information can be collected that reveals the country of origin of radiological isotopes - all of this due to a commercial microwave ...

Recommended for you

Swatting chikungunya

4 hours ago

Summer days may be waning, but health officials are still on high alert for new cases of chikungunya, a painful mosquito-borne virus that spread to the United States from the tropics earlier this year. ...

Sierra Leone readies for controversial Ebola lockdown

4 hours ago

Sierra Leone prepared Thursday for an unprecedented three-day nationwide lockdown to contain the deadly spread of the Ebola virus in a controversial move which experts claimed could worsen the epidemic.

Nepal adopts jab to boost polio fight

4 hours ago

Nepal on Thursday launched a drive to eradicate polio by supplementing oral vaccines with an injection that experts say will boost children's immunity against the disease.

User comments : 0