Bronchopulmonary dysplasia (BPD) is recognised as an important cause of morbidity and mortality in the preterm infants. Despite the use of surfactant administration the incidence of BPD has remained unchanged. With multifactorial causes contributing to the complex entity of BPD, the role of congenital infections in its development is still controversial. The objective of this study is to determine whether the early detection of bacteria or viruses in the airways of preterm infants is associated with the development of BPD.

METHODS: We studied consecutive newborns below 30 weeks of gestation, admitted to the Neonatal Intensive Care Unit of Texas Children's Hospital, Houston, TX. Their tracheal aspirates were obtained within the first week of life and after extraction of nucleic acid we screened by polymerase chain reaction (PCR) for adenoviruses, enteroviruses, cytomegalovirus and with the universal bacterial primers for bacterial agents. BPD was defined as persistent oxygen dependence at one month of age.

RESULTS: Out of 41 infants born prior to 30 weeks gestation, 20 developed BPD (including one infant that subsequently died) and 11 (control group) had no BPD. 10 other infants expired prior to the 30 day time point for BPD diagnosis. In the control group 1 patient was positive for CMV and another was positive enterovirus. In the BPD group, 4 patients were positive for adenovirus: no adenovirus was detected in any of the control group samples. Among the infants that expired, 1 was positive for enterovirus. 18 of the BPD patients, 10 of the control group and all of the dead infants were positive for bacteria.

CONCLUSIONS: These data suggest that congenital adenoviral infection may be associated with the development of BPD in premature infants. Further studies are indicated to confirm this association due to the small sample size. We are currently sequencing the bacterial PCR products to identify the bacterial strains detected and determine if there is a correlation between bacterial type and the development of BPD.