title: High levels of CXCL8 in tracheal aspirate samples taken at birth are associated with adverse respiratory outcome only in preterm infants younger than 28 weeks gestation.
abstract: We investigated the relation between perinatal endotracheal colonization, the associated cytokine response and respiratory outcome in ventilated preterm neonates. Between September 1999 and March 2002, a cohort of 141 neonates with a gestational age <31 weeks requiring ventilation directly after birth, were followed prospectively. All were admitted to the Neonatal Intensive Care Unit, University Hospital of Antwerp, Belgium. A tracheal aspirate (TA) sample was collected soon after birth and was processed for microbiological examination, leukocyte count, and cytokine analysis (interleukins [IL] IL-1beta, IL-6, CXCL8 (formerly called IL-8), IL-10, IL-12p70 and tumor necrosis factor alpha [TNF-alpha]). Together with the prospectively registered patient's comorbidities and severity of disease, these inflammatory parameters were analyzed in a multivariate Cox proportional hazards model with time of extubation and duration of oxygen therapy as main outcome measures. Of the 141 patients included, 31 (22%) died before discharge from the unit and 37 (26%) had a positive TA culture. Independent predictors of duration of mechanical ventilation were: gestational age <28 weeks, degree of respiratory distress syndrome (RDS) at birth, significant patent ductus arteriosus (PDA), the SNAP-score, and high levels of CXCL8 (>4,153 pg/ml) in TA only in neonates with a gestational age <28 weeks. Variables associated with extended duration of oxygen therapy were gestational age <28 weeks, birth weight <1,000 g, degree of RDS at birth, and duration of mechanical ventilation.
authors.affiliation: Faculty of Medicine, Division of Neonatology, Department of Paediatrics, University of Antwerp, Antwerp, Belgium.
authors.forename: Jozef
authors.initials: J
authors.lastname: De Dooy
authors.forename: Margareta
authors.initials: M
authors.lastname: Ieven
authors.forename: Wim
authors.initials: W
authors.lastname: Stevens
authors.forename: Luc
authors.initials: L
authors.lastname: De Clerck
authors.forename: Ludo
authors.initials: L
authors.lastname: Mahieu
mesh_terms: D001826:Body Fluids / Q000737:chemistry*; D001997:Bronchopulmonary Dysplasia / Q000276:immunology* / Q000382:microbiology; D016207:Cytokines / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016209:Interleukin-8 / Q000032:analysis*; D007958:Leukocyte Count; D011379:Prognosis; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000276:immunology* / Q000382:microbiology; D012307:Risk Factors; D014132:Trachea
chemical_list: C508606:CXCL8 protein, human; D016207:Cytokines; D016209:Interleukin-8