Ophthalmia neonatorum in a tertiary referral children’s hospital: A retrospective study

Abstract

Objectives: The purpose of this study was to examine the aetiology, investigation and management of ophthalmia neonatorum (ON) presenting to a tertiary referral children’s hospital over 5 years. Methods: The eye swab data of all neonates presenting to Children’s Health Ireland at Temple Street (Dublin, Ireland) between 1st January 2013 and 3rd September 2018 was analysed. The medical records of all patients with positive eye swab results were retrospectively reviewed. Results: A total of 157 neonates had positive eye swab results. 54 cases were identified as ON. Chlamydia trachomatis (20.4%) was the most common organism identified, followed by Staphylococcus aureus (18.5%), Haemophilus influenzae (14.8%), Moraxella catarrhalis (7.4%), Streptococcus pneumoniae (5.6%), Escherischia coli (3.7%), Klebsiella pneumoniae (1.9%) and Pseudomonas aeruginosa (1.9%). A bacterial culture swab was tested in all cases (100%), a C. trachomatis/N. gonorrhoeae PCR swab in 70.4% and a viral PCR swab in 35.2%. On subanalysis of the cases that had C. trachomatis/N. gonorrhoeae PCR testing, C. trachomatis was responsible for 28.9% of cases. 50% of cases were hospitalised, intravenous antibiotics were administered in 46.3% and macrolide therapy was prescribed in 38.9%. Conclusions: C. trachomatis was the most common cause of ON in this study and may be responsible for an even higher proportion of cases due to incomplete testing. In keeping with studies in different populations, S. aureus, H. influenzae and S. pneumoniae were also common. As a result, an improved management algorithm for cases of ON has been introduced in this centre.

Intersociety Position Statement on the Prevention of Ophthalmia Neonatorum in Italy

“…Recent data from Ireland show that over a 5-year period, the most frequent etiologic agent of ON was C. trachomatis , accounting for 20.4% of all reported cases, while no cases of gonococcal infection were reported [ 9 ]. In case series from Hong Kong, Iran, Norway and Ghana, the most frequent isolates were Staphylococcus aureus [ 10 , 11 , 12 ] or Staphylococcus spp.…”