In case 4, the newborn lived only Volasertib one hour, and the corresponding microbiological cultures were not performed. The intentional search for DNA from Mycoplasma and Chlamydia in postmortem tissues using polymerase chain reaction resulted in amplification of the 129 bp C. trachomatis omp1 gene in five neonates. It was amplified in two or more organs for cases 1, 2, 3, and 4, and only in the kidney for case 6. In case 8, a 715 bp product, corresponding to Mycoplasma, was amplified in lung and kidney tissues (image not

shown). Chlamydial DNA was found in tissues of cases 2 and 6, but with no clinical or histopathological correlation indicating infection. These cases only presented with prematurity, barotrauma, and pulmonary hemorrhage. Additionally, amplification RG7204 chemical structure of 1,142 bp and 879 bp fragments for RFLP analysis of samples positive for chlamydial DNA was only achieved for cases 1, 3, and 4 (Fig. 1). The RFLP analysis of the samples where amplification of the 879 bp fragment was achieved only allowed for the identification of genotype D of C. trachomatis (case 1; Fig. 2). In cases 2 and 6, it was not possible to amplify the 1,142 bp fragment, and the presence of chlamydial DNA was confirmed in liver tissue through real-time polymerase chain reaction only for case

2 (image not shown). All cases were endotracheally intubated and received ventilatory assistance during their entire life. Six cases of premature membrane rupture were found.

Of these, two neonates (cases 1 and 3) had evidence of chlamydial DNA and remained in utero with ruptured membranes for 8 and 6 days, Morin Hydrate respectively. The clinical characteristics of all cases are shown in Table 2. The causes of death in the remaining cases (cases 5 to 7 and 9 to 14) were not associated with infection. Four (29%) died due to causes related with their premature birth, three (21%) due to structural congenital defects not compatible with life, one due to hydrops fetalis of non-immunological origin with severe preeclampsia, and one due to maternal-fetal isoimmunization to Rh. All these cases had negative polymerase chain reaction results for C. trachomatis and Mycoplasma spp., with the exception of case 6, previously mentioned. Severe infections are still the main cause of neonatal morbidity and mortality in developing regions. Three-fourths of infant mortality cases occur during the first week of life, and in many cases, the cause of death remains unknown.23 Chlamydial infection in the perinatal and neonatal stage can cause many diseases. These include conjunctivitis, nasopharyngitis, pneumonitis, and less frequently, rhinitis, middle ear otitis, myocarditis, and encephalitis.4 However, the discovery of genetic residues of this intracellular bacterium in organic tissues is quite rare in the medical literature.