Isolation of Separate Ureaplasma Species From Endotracheal Secretions of Twin Patients

 Isolation   of   Ureaplasma   spp.   from   preterm   neonates   and   the   association   with   development   of   bronchopulmonary   dysplasia   has   been   previously   investigated.   However, few studies have contrasted the nature of infection in twins.  Here we report that  dizygotic  twins  (1  female,  1  male)  born  at  24  weeks  gestation  both  yielded  culturable Ureaplasmafrom  endotracheal  secretions.    The  samples  were  part  of  a  serial blind collection cohort of ventilated premature neonates, and analysis of repeat cultures   showed   stable   separate   infections   over   a   period   of   17   and   21   days   respectively.    Immunoblot  and  probe-specific  qPCR  analysis  determined  that  Twin1 was solely infected   with   Ureaplasma   parvum   (specifically   serovar   6   by   gene   sequencing),   while   Twin2   was   solely   infected   with   Ureaplasma urealyticum(specifically  genotype  A-   serovars  2,  5,  and  8  by  gene  sequencing).    Immunoblot  analysis found that the major surface antigen (multiple-banded antigen; MBA) altered relative  mass  for  both  strains  during  the  course  of  infection.  Quantitative  PCR  analysis of extracted endotracheal aspirates confirmed no evidence of mixed infection for  either  twin.    Failure  of  sentinel  ventilated  preterm  infants  on  the  same  ward  to  acquire Ureaplasmainfection  after  the  first  week  of  birth  suggest  no  cot-to-cot transfer  of  Ureaplasma  infection occurred.    This  study  demonstrated  not  only  a  contrasting clinical  outcome  for  a  set  of  twins  infected  with  two  separate  species  of  Ureaplasma,  but  also  the  first  real-time  demonstration  of  MBA  alteration  and  evolution of Ureaplasma over the course of a clinical infection.