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DOI: 10.1055/a-1580-3069
The Association between Early Gram-Negative Bacteria in Tracheal Aspirate Cultures and Severe Bronchopulmonary Dysplasia among Extremely Preterm Infants Requiring Prolonged Ventilation
Autor*innen
Funding None.
Abstract
Objective The study aimed to evaluate the association between bronchopulmonary dysplasia (BPD) development at 36 weeks' postmenstrual age (PMA) and Gram-negative bacteria in tracheal aspirate cultures among extremely preterm infants.
Study Design This study has a retrospective cohort. Patients were 155 infants aged less than or equal to 26 gestational weeks who were admitted to the neonatal intensive care unit of Osaka Women's and Children's Hospital from 2009 to 2018. Primary outcome was respiratory outcomes expressed as BPD development.
Multivariable logistic regression analysis was used to identify neonatal and bacterial factors associated with BPD.
Results After adjusting for gestational age, birth weight, sex, chorioamnionitis, Gram-positive cocci (GPC) and Gram-negative rods (GNRs) in tracheal aspirate cultures within 28 days after birth, GNRs were significantly associated with BPD development (odds ratio [OR]: 3.88, 95% confidence interval [CI]: 1.68–8.94). In contrast, GPCs were not associated with BPD development (OR: 0.47, 95% CI: 0.05–1.61).
Conclusion Gram-negative bacteria in tracheal cultures within 28 days of birth are associated with BPD development in infants aged less than or equal to 26 gestational weeks.
Key Points
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BPD is a factor for morbidity in extremely preterm infants.
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Respiratory infection is an adverse outcome of BPD.
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GNRs in tracheal cultures soon after birth disturb BPD development.
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GPC was not associated with BPD development.
Publikationsverlauf
Eingereicht: 22. November 2020
Angenommen: 05. August 2021
Accepted Manuscript online:
06. August 2021
Artikel online veröffentlicht:
09. September 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Hirata K, Nishihara M, Kimura T. et al. Longitudinal impairment of lung function in school-age children with extremely low birth weights. Pediatr Pulmonol 2017; 52 (06) 779-786
- 2 Hirata K, Nishihara M, Shiraishi J, Hirano S, Kitajima H, Fujimura M. Perinatal factors associated with long-term respiratory sequelae in ELBW. Arch Dis Child Fetal Neonatal Ed 2014; 0: F1-F6
- 3 Miyake F, Ito M, Minami H, Tamura M, Namba F. Management of bronchopulmonary dysplasia in Japan: a 10-year nationwide survey. Pediatr Neonatol 2020; 61 (03) 272-278
- 4 Fujimura M, Takeuchi T, Kitajima H, Nakayama M. Chorioamnionitis and serum IgM in Wilson-Mikity syndrome. Arch Dis Child 1989; 64 (10 Spec No): 1379-1383
- 5 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729
- 6 Stoll BJ, Hansen NI, Adams-Chapman I. et al; National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA 2004; 292 (19) 2357-2365
- 7 Bruce MC, Schuyler M, Martin RJ, Starcher BC, Tomashefski Jr JF, Wedig KE. Risk factors for the degradation of lung elastic fibers in the ventilated neonate. Implications for impaired lung development in bronchopulmonary dysplasia. Am Rev Respir Dis 1992; 146 (01) 204-212
- 8 Lohmann P, Luna RA, Hollister EB. et al. The airway microbiome of intubated premature infants: characteristics and changes that predict the development of bronchopulmonary dysplasia. Pediatr Res 2014; 76 (03) 294-301
- 9 Mourani PM, Harris JK, Sontag MK, Robertson CE, Abman SH. Molecular identification of bacteria in tracheal aspirate fluid from mechanically ventilated preterm infants. PLoS One 2011; 6 (10) e25959
- 10 Lal CV, Travers C, Aghai ZH. et al. The airway microbiome at birth. Sci Rep 2016; 6: 31023
- 11 Lowe J, Watkins WJ, Edwards MO. et al. Association between pulmonary ureaplasma colonization and bronchopulmonary dysplasia in preterm infants: updated systematic review and meta-analysis. Pediatr Infect Dis J 2014; 33 (07) 697-702
- 12 Cordero L, Sananes M, Dedhiya P, Ayers LW. Purulence and gram-negative bacilli in tracheal aspirates of mechanically ventilated very low birth weight infants. J Perinatol 2001; 21 (06) 376-381
- 13 Beeton ML, Maxwell NC, Davies PL. et al. Role of pulmonary infection in the development of chronic lung disease of prematurity. Eur Respir J 2011; 37 (06) 1424-1430
- 14 Itabashi K, Miura F, Uehara R, Nakamura Y. New Japanese neonatal anthropometric charts for gestational age at birth. Pediatrics international: official journal of the Japan Pediatric Society 2014; 56 (05) 702-708
- 15 Bell MJ, Ternberg JL, Feigin RD. et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978; 187 (01) 1-7
- 16 Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92 (04) 529-534
- 17 Tramper J. The Association between positive tracheal aspirate cultures and adverse pulmonary outcomes in preterm infants with severe BPD. Am J Perinatol 2017; 34: 96-104
- 18 Cordero L, Ayers LW, Davis K. Neonatal airway colonization with gram-negative bacilli: association with severity of bronchopulmonary dysplasia. Pediatr Infect Dis J 1997; 16 (01) 18-23
- 19 Groneck P, Schmale J, Soditt V. Bronchoalvelar inflammation following airway infection in preterm infants with chronic lung disease. Peddiatric pulmonology 2001; 31: 331-338
- 20 Kramer BW, Kramer S, Ikegami M, Jobe AH. Injury, inflammation, and remodeling in fetal sheep lung after intra-amniotic endotoxin. Am J Physiol Lung Cell Mol Physiol 2002; 283 (02) L452-L459
- 21 Sadikot RT, Blackwell TS, Christman JW, Prince AS. Pathogen-host interactions in Pseudomonas aeruginosa pneumonia. Am J Respir Crit Care Med 2005; 171 (11) 1209-1223
- 22 Imamura T, Sato M, Go H. et al. The microbiome of the lower respiratory tract in premature infants with and without severe bronchopulmonary dysplasia. Am J Perinatol 2017; 34 (01) 80-87
- 23 Suzumura H, Nitta A, Tanaka G, Kuwashima S, Hirabayashi H. Role of infection in the development of acquired subglottic stenosis in neonates with prolonged intubation. Pediatrics international: official journal of the Japan Pediatric Society 2000; 42 (05) 508-513
- 24 Yamada Y, Sugai M, Woo M, Nishida N, Sugimoto T. Acquired subglottic stenosis caused by methicillin resistant Staphylococcus aureus that produce epidermal cell differentiation inhibitor. Arch Dis Child Fetal Neonatal Ed 2001; 84 (01) F38-F39
- 25 Budden KF, Gellatly SL, Wood DL. et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol 2017; 15 (01) 55-63
- 26 Dickson RP, Huffnagle GB. The lung microbiome: new principles for respiratory bacteriology in health and disease. PLoS Pathog 2015; 11 (07) e1004923
- 27 Beck JM. ABCs of the lung microbiome. Ann Am Thorac Soc 2014; 11 (Suppl. 01) S3-S6
- 28 Wagner BD, Sontag MK, Harris JK. et al. Airway microbial community turnover differs by BPD severity in ventilated preterm infants. PLoS One 2017; 12 (01) e0170120
- 29 Ryan FJ, Drew DP, Douglas C. et al. Changes in the composition of the gut microbiota and the blood transcriptome in preterm infants at less than 29 weeks gestation diagnosed with bronchopulmonary dysplasia. mSystems 2019; 4 (05) 1-17
- 30 Resch B, Gutmann C, Reiterer F, Luxner J, Urlesberger B. Neonatal ureaplasma urealyticum colonization increases pulmonary and cerebral morbidity despite treatment with macrolide antibiotics. Infection 2016; 44 (03) 323-327