Nosocomial <i>Pseudomonas aeruginosa</i> Conjunctivitis in a Pediatric Hospital

King, Susan; Devi, Shashi; Mindorff, Catherine; Patrick, Mary Lou; Gold, Ronald; Ford-Jones, E. Lee

doi:10.1086/645789

Cited by 20 publications

(11 citation statements)

References 11 publications

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“…Patients in ICU are more exposed to pathogenic microorganisms with significant antimicrobial resistance resulting from the widespread use of multiple antibiotics, which also increases the risk of conjunctivitis and keratitis [ 3 , 4 ]. Conjunctivitis is a common complication within the ICU setting and without the necessary care; this condition can spread rapidly among the patients [ 1 , 2 , 6 , 13 , 14 ]. In the study of King et al [ 13 ], Pseudomonas aeruginosa was recovered from the conjunctiva of 30 patients in a university-affiliated pediatric hospital and 70% of cases occurred in pediatric ICU (PICU) patients.…”

Section: Discussionmentioning

confidence: 99%

Ocular Surface Disorders in Intensive Care Unit Patients

Sarıtaş

Bozkurt

Şimşek

et al. 2013

The Scientific World Journal

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Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 ± 18.15 years (range 17–74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 ± 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 ± 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.

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Section: Discussionmentioning

confidence: 99%

Ocular Surface Disorders in Intensive Care Unit Patients

Sarıtaş

Bozkurt

Şimşek

et al. 2013

The Scientific World Journal

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“…aeruginosa conjunctivitis during infancy may lead to a rapidly progressive, invasive eye infection. In some cases this destructive eye disease is associated with or followed by infection at other sites, but there have been cases of P. aeruginosa conjunctivitis in hospitalized, premature infants who developed systemic complications without invasive eye infection [4,5].…”

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confidence: 99%

An outbreak of conjunctivitis caused by multiresistant Pseudomonas aeruginosa in a Brazilian Newborn Intensive Care Unit

Dv¹,

Ej²,

Matos³

et al. 2003

Braz J Infect Dis

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We report an outbreak of conjunctivitis due to Pseudomonas aeruginosa involving seven infants admitted in the Neonatal Intensive Care Unit (NICU) of the Uberlândial Federal University Hospital between March and September 2001. Three infants developed systemic complications (01 sepsis and 02 pneumonias). Ten isolates were obtained from conjunctival cultures and all were resistant to ceftazidime and aminoglycosides. Fast identification of the organism and treatment with imipenem were important in containing the outbreak of P. aeruginosa.

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“…3 P. aeruginosa comprises 1.2% to 5.9% of all cases of neonatal conjunctivitis, 4 -6 and extraocular colonization with P. aeruginosa, particularly in the respiratory tract, may be a predisposing factor. 7 P. aeruginosa conjunctivitis in infancy may be associated with significant morbidity and mortality due to the development of both ophthalmic and systemic complications ( Table 1). The infection begins as a purulent conjunctivitis and may progress to infiltration of the corneal stroma.…”

Section: Discussionmentioning

confidence: 99%

Bacteremia, Meningitis, and Brain Abscesses in a Hospitalized Infant: Complications of Pseudomonas aeruginosa Conjunctivitis

1999

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This report describes a preterm infant hospitalized in a neonatal intensive care unit who developed Pseudomonas aeruginosa conjunctivitis associated with bacteremia, meningitis, and multiple brain abscesses. P. aeruginosa conjunctivitis can rapidly progress to an invasive eye infection, such as corneal ulceration or endophthalmitis, leading to poor vision or blindness. Progression of this infection may lead to systemic disease. However, as illustrated in this report, P. aeruginosa conjunctivitis may be associated with the development of systemic complications such as bacteremia and meningitis in the absence of invasive eye disease. P. aeruginosa is a relatively common cause of conjunctivitis in hospitalized preterm and low birth weight infants. Given the severity of the ocular and systemic complications of Pseudomonas conjunctivitis, clinicians are reminded that prompt detection and treatment of neonatal conjunctivitis is critical. CASE REPORTAn infant boy was born by cesarean section at 27 weeks' gestation due to a prolapsed umbilical cord. The infant's birth weight was 910 gm, and Apgar scores were 5 and 6 at 1 and 5 minutes, respectively. The infant required mechanical ventilation for treatment of respiratory distress syndrome for the first 11 days of life. On day 12 of life, a purulent conjunctivitis of the right eye was noted and a conjunctival bacterial culture was obtained.On day 13 of life, the infant developed signs and symptoms of septic shock. Physical exam was remarkable for a heart rate of 220 beats per minute, respirations at 40 to 50/min, and blood pressure at 30/20 mm Hg. The infant was lethargic but had normal upper and lower extremity tone. The anterior fontanelle was flat. There was decreased perfusion with cold extremities and delayed capillary refill. This deterioration was accompanied by metabolic acidosis. The white blood cell count was 50,900/mm 3 with 59% segmented neutrophils and 17% band forms. The platelet count was 20,000/mm 3 , and prothrombin and partial thromboplastin times were prolonged at 26.5 seconds and Ͼ2 minutes, respectively. Cerebrospinal fluid examination revealed a glucose of 22 mg/dl, a protein of 164 mg/dl, 5/mm 3 erythrocytes, and 387/mm 3 leukocytes. Blood, urine, endotracheal secretion, and cerebrospinal fluid cultures were obtained. Cranial ultrasonography was normal. Treatment included intravenous fluid boluses, dopamine infusion, mechanical ventilation, and transfusion with packed red blood cells, fresh frozen plasma, and platelets. Intravenous ampicillin and ceftriaxone were prescribed. These were subsequently changed to intravenous gentamicin and ceftazidime when Pseudomonas aeruginosa was isolated from blood, endotracheal, and conjunctival cultures. Both eyes were treated with ophthalmic gentamicin ointment.The infant's condition remained poor over the next week. Although his conjunctivitis had resolved, he was still lethargic with poor perfusion. He continued to require mechanical ventilation and pressor support as well as multiple packed red blood cell, pla...

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Nosocomial Pseudomonas aeruginosa Conjunctivitis in a Pediatric Hospital

Cited by 20 publications

References 11 publications

Ocular Surface Disorders in Intensive Care Unit Patients

Ocular Surface Disorders in Intensive Care Unit Patients

An outbreak of conjunctivitis caused by multiresistant Pseudomonas aeruginosa in a Brazilian Newborn Intensive Care Unit

Bacteremia, Meningitis, and Brain Abscesses in a Hospitalized Infant: Complications of Pseudomonas aeruginosa Conjunctivitis

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