Healthcare-Associated Conjunctivitis in the NICU: Microbiological Spectrum, Antimicrobial Resistance and Treatment...

Area of Science:

• Neonatal infectious diseases
• Ophthalmology
• Microbiology

Background:

• Healthcare-associated bacterial conjunctivitis is a preventable infection in neonatal intensive care units (NICUs).
• Understanding its incidence, risk factors, and microbiological profile is crucial for effective management in neonates.

Purpose of the Study:

• To determine the incidence, risk factors, microbiological profile, and treatment of healthcare-associated bacterial conjunctivitis in neonates admitted to the NICU.
• To analyze the clinical burden associated with Gram-positive versus Gram-negative pathogens.

Main Methods:

• A descriptive, cross-sectional study was conducted in a NICU from January 2019 to January 2024.
• Pathogen identification used MALDI-TOF MS, and antimicrobial susceptibility was determined by VITEK 2.
• Data included 4107 neonates, with 104 diagnosed with bacterial conjunctivitis.

Main Results:

• The incidence of healthcare-associated bacterial conjunctivitis was 2.5% (104/4107 neonates).
• Gram-positive bacteria (70.2%) were predominant, with coagulase-negative staphylococci (52.9%) being most common, followed by *Staphylococcus aureus*, *Klebsiella pneumoniae*, and *Serratia marcescens*.
• Gram-negative infections were linked to longer intubation, feeding, and hospitalization durations.

Conclusions:

• Neonatal conjunctivitis acquired in NICUs is mainly caused by Gram-positive bacteria.
• Gram-negative infections present a greater clinical burden, necessitating careful monitoring and management.
• Fortified antibiotic eye drops are effective for treating resistant cases in high-risk newborns.