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Background   Ureaplasma urealyticum  and  U. parvum  have been associated with respiratory diseases in premature newborns, but their role in the pathogenesis of the respiratory distress syndrome (RDS) is unclear. The aim of this study was to detect, using molecular techniques, the role of  Mycoplasma  spp. and  Ureaplasma  spp. in respiratory secretion and blood specimens of preterm newborns with or without RDS and to evaluate the prevalence of perinatal  U. urealyticum  or  U. parvum  infection. The influence of chemotherapy on the clinical course was also evaluated.    Methods  Tracheal aspirate or nasopharingeal fluid samples from 50 preterm babies with (24) or without RDS (26) were analysed for detection of  U. urealyticum  and  U. parvum  by culture identification assay and PCR. Sequencing analysis of amplicons allowed us to verify the specificity of methods. Clarithromycin (10 mg kg -1  twice a day) was administered in ureaplasma-positive patients who presented clinical signs of RDS.    Results  15/24 neonates with RDS (p < 0.001) and 4/26 without RDS were found PCR-positive for  U. urealyticum  or  U. parvum . Culture identification assay was positive in 5/50 newborns, three of which with RDS. Sequencing analyses confirmed the specificity of these methods. Association of patent ductus arteriosus with ureaplasma colonization was more statistically significant (p = 0.0004) in patients with RDS than in those without RDS.    Conclusion  Colonization of the lower respiratory tract by  Ureaplasma  spp. and particularly by  U. parvum  in preterm newborns was related to RDS. The routine use of molecular methods could be useful to screen candidate babies for etiologic therapy.

Molecular evidence of Ureaplasma urealyticum and Ureaplasma parvum colonization in preterm infants during respiratory distress syndrome