Incidence of Chlamydia trachomatis and other potential pathogens in neonatal conjunctivitis

• Published in: International journal of infectious diseases Vol. 5; no. 3; pp. 139 - 143
• Main Authors: Bartolomeo, Susana Di, Mirta, Delia Higa, Janer, Margarita, Fermepin, Marcelo Rodríguez, Sauka, Diego, Magarinos, Francisco, de Torres, Ramón Alberto
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 2001; Elsevier
• Subjects: Age Factors; Bacterial diseases; Bacterial diseases of the eye and orbit; Biological and medical sciences; Chlamydia trachomatis; Chlamydia trachomatis - isolation & purification; conjunctivitis; Conjunctivitis, Bacterial - microbiology; Haemophilus influenzae - isolation & purification; Human bacterial diseases; Humans; Incidence; Infant, Newborn; Infectious diseases; Medical sciences; neonates; Streptococcus pneumoniae - isolation & purification; Tropical medicine; South America; Argentina; America; conjunctivitis; Chlamydia trachomatis; neonates; Human; Neonatal; Chlamydiaceae; Pathogenesis; Conjunctiva disease; Conjunctivitis; Epidemiology; Incidence; Infection; Eye disease; Microbiological investigation; Newborn; Etiology; Bacteriosis; Chlamydiales; Bacteria; Chlamydiosis
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/S1201-9712(01)90088-8

Objective: Ocular infection in neonatology is a permanent and important health problem. To improve primary attention, prevention, and control, the study of the potential bacterial etiology of all consecutive cases of conjunctivitis was incorporated as a regular procedure in primary care from July 1995 to December 1998.
Materials and Methods: Prof. A. Posadas Hospital (Great Buenos Aires) has an average of 4294 births per year. This report analyzes the results obtained in 332 infants (age range, 0–30 d) with conjunctivitis. Clinical conjunctivitis was diagnosed in inpatients and outpatients by the same specialized staff. Isolation and characterization of bacteria were done by conventional microbiologic methods, including specific search for
Neisseria gonorrhoeae and
Chlamydia trachomatis.
Chlamydia trachomatis was studied by antigen immunodetection and polymerase chain reaction, and genotyped by restriction fragment length polymorphism.
Results: Conjunctivitis had an incidence (cases per 1000 live births) of 39.6 in 1995, 25.3 in 1996, 15.4 in 1997, and 15.2 in 1998. Microbial growth was detected in 167 (50.3%) of 332 cases. Ocular
C. trachomatis infection was detected in 26 cases (7.83%). Five of seven isolates in tissue cultures belonged to type E and two to type G. Bacteria from respiratory ecology were the main isolates:
Haemophilus influenzae (16.9%),
Streptococcus pneumoniae (12.3%), and Staphylococcus aureus (8.7%).
Haemophilus influenzae isolates were not serotyped and 17.2% of them were β-lactamase producers. In 15 cases both
H. influenzae and
S. pneumoniae were isolated together. Of
S. pneumoniae, 4,9% were oxacillin resistant.
Conclusions: There has been a decline in the total number of cases of neonatal conjunctivitis, but the disease is still an important health problem.
Chlamydia trachomatis also shows a decreasing profile with an incidence of (cases per 1000 live births) 4.39 in 1995, 1.85 in 1996, 1.01 in 1997, and 0.78 in 1998, and a tendency to show more incidence in spring-summer and significant accumulation of cases in babies between 7 and 9 days of age.
Haemophilus influenzae alone (12.3%) or associated with
S. pneumoniae (4.5%) appears as a prevalent potential bacterial pathogen. A significant accumulation of
H. influenzae and
S. pneumoniae cases occurs in winter. In 47.6% of cases, there was no bacterial growth. No significant seasonal differences in percentage of negative cultures or among the three-day age groups were detected.
Neisseria gonorrhoeae was not found associated with ophthalmia neonatorum in this series.