Original Article

Journal of Perinatology (2005) 25, 403–407. doi:10.1038/sj.jp.7211297 Published online 21 April 2005

The Association between Early Tracheal Colonization and Bronchopulmonary Dysplasia

Karen C Young MD1, Teresa del Moral MD, MPH1, Nelson Claure PhD1, Silvia Vanbuskirk RN, BSN1 and Eduardo Bancalari MD1

1Division of Newborn Medicine, Department of Pediatrics, University of Miami School of Medicine, Miami, FL, USA

Correspondence: Teresa del Moral, University of Miami School of Medicine, Department of Pediatrics (R-131), PO Box 016960, Miami, Fl 33101, USA

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Abstract

OBJECTIVE:

 

To evaluate the relationship between early tracheal colonization and bronchopulmonary dysplasia (BPD).

STUDY DESIGN:

 

This is a retrospective cohort study which included 308 inborn neonates admitted to the newborn intensive care unit at the University of Miami Jackson Memorial Medical Center between January 1997 and December 2000 with birthweight 500 to 1000 g, who required mechanical ventilation on the first day of life. Chorioamnionitis was diagnosed by maternal symptoms and histopathopathology. Tracheal cultures were obtained immediately after tracheal intubation. BPD was diagnosed in neonates who had supplemental oxygen requirement for more than 28 days. Pearson's chi2 and Logistic Regression Analysis were used to evaluate the relationship between chorioamnionitis, positive initial tracheal cultures and BPD, after adjusting for confounding variables.

RESULTS:

 

In patients with chorioamnionitis, the incidence of early positive tracheal cultures was 41% compared to 16% in those without chorioamnionitis, (p<0.00001). In patients with birthweight 700 to 1000 g, a positive early tracheal culture increased the risk of BPD (OR=2.42, CI 1.05 to 5.62, p<0.05).

CONCLUSION:

 

Preterm infants exposed to chorioamnionitis have an increased incidence of early tracheal colonization. This early tracheal colonization may predispose them to develop BPD.

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