Gonococcal infection of the newborn in Florida, 1984-1989

An increase in neonatal gonococcal infections was recorded in Florida between 1984 and 1988. By reviewing Florida sexually transmitted disease surveillance case records between 1984 and 1989, 68 cases of neonatal gonococcal infections were identified state-wide. Those 68 cases included 55 (81%) cases of gonococcal ophthalmia neonatorum, 4 genital infections, 1 nasal infection, 1 ear infection, 1 skin infection, and 1 scalp infection. At birth, positive culture results were demonstrated in 3 gastric and 2 respiratory aspirate cultures. A case-control study using birth certificates as the source of information showed that mothers of infected infants were more likely to be younger, black (odds ratio [OR] = 6.2; 95% confidence interval [CI] 2.3, 16.2), and less educated (less than a high school education, OR = 2.9, CI 1.0,8.8) in comparison to mothers of control subjects. Although mothers of infected newborns were less likely to have received prenatal care than were mothers of control subjects, this difference was not statistically significant. Maternal substance abuse was documented among 19% of the mothers of the infected infants. The rate of clinical gonococcal ophthalmia neonatorum in Florida hospitals from which cases had been reported was 1.7 per 10,000 live births, and tended to be higher in hospitals using erythromycin than in hospitals using any other prophylactic eye treatment. This study suggests that the rate of neonatal gonococcal infection, in particular ophthalmia neonatorum, may have increased in Florida among high-risk populations between 1984 and 1988, and underscores the need for targeted prevention efforts and surveillance.