Ophthalmia neonatorum today

Ophthalmia neonatorum in Bangkok: the significance of Chlamydia trachomatis

In a prospective 2-month case-controlled study, 17 cases of neonatal conjunctivitis were diagnosed. A statistically significant association between neonatal conjunctivitis and the presence of Chlamydia trachomatis (five cases) and Staphylococcus aureus (five cases) was shown. No cases of gonococcal conjunctivitis were found, perhaps because of the routine use of silver nitrate (1%) drops. C. trachomatis conjunctivitis could not be diagnosed on clinical grounds, nor was examination of Giemsa-stained conjunctival scrapes sufficiently sensitive to detect all cases. In order to prevent the long-term morbidity of C. trachomatis infection in both mother and child, specific aetiological diagnosis using immunodiagnostic or cultural procedures is required.

Adult follicular conjunctivitis and neonatal ophthalmia in a Liverpool eye hospital, 1980-1984

In the five year period between 1980 and 1984, 2146 adults and 172 neonates suffering from acute conjunctivitis underwent laboratory investigation for Chlamydia trachomatis (CT), Adenoviruses (AV), Herpes Simplex Virus (HSV) and pathogenic bacteria. Epidemiology and clinical features are presented and discussed. CT was detected in 29 per cent of neonates with conjunctivitis. 5.6 per cent of adults and older children investigated for follicular conjunctivitis were CT positive. There was a significant female preponderance among CT positive neonates of 1.9:1 (p less than 0.02). 91 per cent of neonates and 62 per cent of adults in whom CT was detected were receiving some sort of treatment. Serotypes 7, 3, 10, 4 and 8 were responsible in decreasing order of frequency for 96 per cent of AV infections. Serotype 7 was seen for the first time in an adult age distribution. HSV was isolated in 1.3 per cent of cases in the absence of typical lid or corneal lesions. Viral infection was not detected in any neonate. Bacterial infection was a more likely cause than CT in neonates if infection had persisted longer than 5 weeks (p much less than 0.001). Neonates with Staph aureus infection tended to present earlier in the course of disease than those with Haemophilus sp or Pneumococcus (p less than 0.05).

Ophthalmia neonatorum in a semi-rural African community

The incidence and aetiology of ophthalmia neonatorum have been estimated over a 7-month period in Franceville, a semi-rural community in south-eastern Gabon. Chlamydia trachomatis was the most frequently observed pathogen, being isolated from 17 babies (2.7% of births), and Neisseria gonorrhoeae was recovered from 12 (1.6% of births). 5 of 17 cases of chlamydial conjunctivitis were in infants less than 5 d old as opposed to 9 in the typical 5 to 10-days-old group. As expected, most cases of gonococcal ophthalmia neonatorum occurred in the first 5 d of life with cases in older infants often not accompanied by a granulocytic response. Chlamydial conjunctivitis was usually unilateral whereas other cases were most frequently bilateral.