Journal List > Korean J Perinatol > v.26(4) > 1013766

Ahn, Lee, Ko, and Shin: Neonatal Bacterial Conjunctivitis: Pathogenic Distribution

Abstract

Purpose

To study the causative microorganism of neonatal bacterial conjunctivitis and its correlation with maternal factors.

Methods

We retrospectively reviewed the medical records of 55 neonates diagnosed with bacterial conjunctivitis and the records of mothers from January 2008 to July 2013. We investigated microbiologic culture of conjunctival discharge, time of occurrence, the mode of delivery, premature rupture of membrane (PROM), microbiologic culture of vaginal swab and the sensitivities to antibiotics.

Results

The most common organism was Staphylococcus epidermidis, isolated in 24 (36.4%) neonates, followed by other Coagulase-negative Staphylococcus (CNS) 10 (15.2%), E. cloacae 6 (9.1%), S. marsescens 6 (9.1%), and P. aeruginosa 5 (7.6%). Concerning the time of occurrence, 23 (41.8%) were founded with conjunctivitis within 1 week of life. By mode of delivery, 18 (32.7%) were delivered through vaginal route and 37 (67.3%) delivered by Cesarean section. The most common organism grown in conjunctival discharge of both group was S. epidermidis. Of these 55 neonates' mothers, 9 (16.4%) had history of PROM. Regardless of the presence of PROM, the most common organism was S. epidermidis. A total of 22 (40.0%) microbiologic culture of vaginal swab were examined and 6 (27.2%) of them had detected organisms. The results of vaginal swabs were in discord with results of conjunctival swabs of neonates.

Conclusion

S. epidermidis was the most common infectious organism of neonatal bacterial conjunctivitis. We could not identify the correlation between neonatal bacterial conjunctivitis and maternal factors. Further comprehensive studies are needed to investigate the risk factors related to bacterial conjunctivitis of neonates.

References

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Table 1.
Clinical Features of Neonatal Bacterial Conjunctivitis (N=55)
Variable No. (%)
Sex
 Male 28 (50.9)
 Female 27 (49.1)
Gestational age  
 <37 weeks 30 (54.5)
 ≥37 weeks 25 (45.5)
Mode of delivery  
Vaginal delivery 18 (32.7)
Cesarean section 37 (67.3)
PROM (>12hrs)
 (+) 9 (16.4)
 (−) 46 (83.6)
Time of diagnosis
 1st week 23 (41.8)
 2nd week 14 (25.5)
 3rd week 14 (25.5)
 4th week 4 (7.2)

Abbreviation: PROM, Premature rupture of membranes

Table 2.
Organisms grown in Conjunctival Swabs
Organism Total No. of Isolates (%)
Staphylococcus epidermidis 24 (36.4)
Other CNS 10 (15.2)
Enterobacter cloacae 6 (9.1)
Serratia marcescens 6 (9.1)
Streptococcus species 6 (9.1)
Pseudomonas aeruginosa 5 (7.6)
Escherichia coli 2 (3.0)
Staphylococcus aureus 3 (4.5)
Corynebacterium pseudodiphtheriticum 1 (1.5)
Enterococcus faecalis 1 (1.5)
Klebsiella pnemoniae 1 (1.5)
Enterobacter aerogenes 1 (1.5)

Includes 10 cases with >1 organism isolated Abbreviation: CNS, Coagulase-negative Staphylococcus

Table 3.
Distribution of Organisms based on Timing of Diagnosis
Organism Total No. of Isolates (%)
1st week 2nd week 3rd week 4th week
S. epidermidis 10 (38.5) 7 (41.1) 7 (38.9) 0
Other CNS 3 (11.5) 1 (5.9) 4 (22.2) 2 (40.0)
E. cloacae 0 4 (23.5) 1 (5.5) 1 (20.0)
S. marcesens 2 (7.7) 1 (5.9) 2 (11.2) 1 (20.0)
Streptococcus species 6 (23.1) 0 0 0
P. aerusinosa 2 (7.7) 1 (5.9) 2 (11.2) 0
E. Coli 0 2 (11.8) 0 0
S. aureus 2 (7.7) 1 (5.9) 0 0
C. pseudodiphtheriticum 1 (3.8) 0 0 0
E. faecalis 0 0 1 (5.5) 0
K. pnemoniae 0 0 0 1 (20.0)
E. aerogenes 0 0 1 (5.5) 0

Includes 10 cases with >1 organism isolated Abbreviation: CNS, Coagulase-negative Staphylococcus

Table 4.
Distribution of Organisms based on Mode of Delivery
Organism Total No. of Isolates (%)
Cesarean section Vaginal delivery
S. epidermidis 16 (37.2) 8 (34.8)
Other CNS 5 (11.6) 5 (21.7)
E. cloacae 5 (11.6) 1 (4.3)
S. marcesens 4 (9.3) 2 (8.7)
Streptococcus species 3 (7.0) 3 (13.0)
P. aerusinosa 4 (9.3) 1 (4.3)
E. Coli 1 (2.3) 1 (4.3)
S. aureus 2 (4.7) 1 (4.3)
C. pseudodiphtheriticum 1 (2.3) 0
E. faecalis 0 1 (4.3)
K. pnemoniae 1 (2.3) 0
E. aerogenes 1 (2.3) 0

Includes 10 cases with >1 organism isolated Abbreviation: CNS, Coagulase-negative Staphylococcus

Table 5.
Organisms grown in Vaginal Swabs of Mother (N=22)
Organism No. (%)
No growth 16 (72.8)
Streptococcus agalactiae 3 (13.7)
Candida albicans 1 (4.5)
Staphylococcus auricularis 1 (4.5)
Lactobacillus 1 (4.5)
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