[Neonatal conjunctivitis in a nursery and a neonatal unit]

Area of Science:

• Neonatal ophthalmology
• Infectious disease epidemiology
• Microbiology

Background:

• Credé prophylaxis discontinuation necessitated enhanced neonatal conjunctivitis surveillance.
• Routine clinical surveillance and bacterial cultures are standard for purulent eye discharge in neonates.

Purpose of the Study:

• To assess the incidence and causative agents of neonatal conjunctivitis after the cessation of Credé prophylaxis.
• To determine the prevalence of Chlamydia trachomatis in neonatal conjunctivitis cases.

Main Methods:

• Prospective study over two years (March 1987-February 1989) involving 4,520 live-born infants.
• Clinical surveillance for conjunctivitis, bacterial cultures, and Chlamydia trachomatis testing (EIA-technique) for affected infants.
• Analysis of bacterial isolates including Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus viridans.

Main Results:

• Conjunctivitis incidence was 7.3% (332/4,520), higher in nurseries (8.2%) than neonatal units (3.5%).
• Staphylococcus aureus (51.5%) was the most common bacterial isolate, followed by Staphylococcus epidermidis (46.1%).
• Chlamydia trachomatis was detected in 3.9% of conjunctivitis cases (0.3% of all live births), with 46% diagnosed in the first week of life.

Conclusions:

• Neonatal conjunctivitis remains a significant concern, with Staphylococcus aureus being the predominant pathogen.
• While Chlamydia trachomatis is less prevalent, its early-onset occurrence warrants consideration in diagnostic protocols.
• Effective prevention strategies should focus on minimizing colonization by pathogenic bacteria, particularly Staphylococcus aureus, in newborn infants.