Chronic
lung disease (CLD) of the newborn is associated with
pulmonary inflammation. However, the origin of this
inflammation is not known. We evaluated the impact of airway
infection on bronchoalveolar
inflammation in mechanically ventilated preterm infant at risk for CLD (n = 68). Mean and maximum concentrations of the inflammatory mediators (IM)
interleukin-1 and
interleukin-8 were assayed in the tracheobronchial aspirate fluid (TAF) of neonates with perinatal airway
infection (Ureaplasma urealyticum, or bacteria), postnatal nosocomial airway
infection, or respiratory disease without airway
infection from days 1-10 of postnatal age. Patients with CLD (n = 23;) exhibited increased levels of IM in TAF compared to neonates without CLD. Within the three subgroups, concentrations of IM were increased in CLD patients with perinatal
infection and in CLD patients with respiratory disease without airway
infection, but not in CLD patients with nosocomial airway
infection. Although airway colonization with Gram-negative bacteria was more frequently found in CLD patients within the first month of life, there were no differences between levels of IM in patients colonized with Gram-negative bacteria or
coagulase-negative staphyloccoci. We conclude that perinatal
infections with Ureaplasma urealyticum or bacteria and respiratory disease without
infection, but not nosocomial airway
infection, contribute to the bronchopulmonary inflammatory response in neonates with CLD.