Document Detail

Bacterial and Ureaplasma colonization of the airway: radiologic findings in infants with bronchopulmonary dysplasia.
MedLine Citation:
PMID:  9447527     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We designed this retrospective study to compare radiologic findings in premature infants with bronchopulmonary dysplasia (BPD) in whom gram-positive cocci (GPC), gram-negative bacilli (GNB), or Ureaplasma urealyticum were colonized. Another objective was to correlate the radiologic findings of these patients with the clinical severity of BPD. STUDY DESIGN: We correlated serial tracheal aspirates with radiographic findings from 183 infants whose birth weight was < or = 1250 gm. BPD severity was assessed by oxygen dependency at 36 weeks of postconceptional age (36 w PCA) and at the time of discharge. Two radiologists independently scored films taken at birth and 1, 7, 14, 21, 28, and 35 days of life. RESULTS: Of the study population, 55% were male and 35% were black; 80% received surfactant and 69% received dexamethasone; 91% survived. GPC isolates from throat cultures were mainly Staphylococcus [corrected] epidermidis and Streptococcus haemolyticus. A superimposed GNB colonization was present in 37% of these infants. Most common isolates were Klebsiella pneumoniae, Enterobacter cloacae, and Escherichia coli. Sepsis caused by GPC developed in 16% of all patients; 7% had sepsis caused by GNB. Infants infected with GNB remained receiving oxygen at 36 w PCA and at the time of discharge twice as often as those noninfected. RADIOLOGIC FINDINGS: Hyperinflation, interstitial changes, and generalized or localized emphysema were prominent features throughout. Mean radiologic scores increased over time in a pattern similar among GPC, GNB, and U. urealyticum infected and noninfected infants. High radiologic scores were not predictive at any time of infants who needed supplemental oxygen at 28 days and at 36 w PCA. Infants infected with U. urealyticum were neither clinically nor radiologically different than noncolonized neonates. CONCLUSION: GPC, GNB, and U. urealyticum airway colonization is not associated with particular radiographic changes at any time. GNB-infected infants had the most severe BPD course, and yet they were radiologically indistinguishable from the other patients. U. urealyticum colonization does not result in more clinically severe BPD or demonstrate a unique radiologic course.
L Cordero; B D Coley; R L Miller; C F Mueller
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  17     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:    1997 Nov-Dec
Date Detail:
Created Date:  1998-03-04     Completed Date:  1998-03-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  428-33     Citation Subset:  IM    
Department of Radiology, Ohio State University, College of Medicine, Columbus, USA.
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MeSH Terms
Bacterial Infections / microbiology,  radiography*
Bronchopulmonary Dysplasia / microbiology,  radiography*
Colony Count, Microbial
Gestational Age
Gram-Positive Cocci / growth & development*,  isolation & purification
Infant, Newborn
Pharynx / microbiology
Radiography, Thoracic
Retrospective Studies
Risk Factors
Severity of Illness Index
Ureaplasma urealyticum / growth & development*,  isolation & purification
Erratum In:
J Perinatol 1998 Jan-Feb;18(1):37

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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