A five-year study in Iran of ophthalmia neonatorum: prevalence and etiology

The aim was to determine the prevalence of conjunctivitis and its bacteriological causes in neonates hospitalized in two hospitals in Iran and to evaluate the maternal and newborns' data in conjunctivitis cases.

All newborns presenting at Imam Khomeini and Vali-e-Asr hospitals (2001-2006) with clinical suspicion of conjunctivitis and positive microbiology were studied. The medical files of those with conjunctivitis were assessed.

Of 4021 neonates examined for the presence of conjunctivitis, 198 (4.9%) had conjunctivitis. Sixty-five percent of the cases had been delivered by cesarean section, 47% and 11% had histories of maternal premature rupture of membrane (PROM) and genitourinary infection, respectively, 65% were preterm, and 61% and 32% had low weight and APGAR score below 7 at birth, respectively. In addition, 22% had septicemia. The most common organism causing ophthalmia was S. aureus (31%), followed by E. coli (23%), S. epidermis (22%), Klebsiella (10%), N. gonorrhea (3%), C. trachomatis (2%), and Pseudomonas aeruginosa (2%). In the neonates with septicemia the most common cause of conjunctivitis was E. coli (38%). Neonates with E. coli conjunctivitis had a significantly (P<0.05) higher rate of a history of maternal genitourinary infection and a higher rate of septicemia than non-E. coli cases.

The prevalence of 4.9% found here is consistent with other reports ranging from 1.6 to 12% of neonates. Data such as birth weight, APGAR score, presence of septicemia, maternal genitourinary infections, and PROM may play a role in the development of neonatal conjunctivitis by different pathogens.