Pathogenic and clinical features of neonatal bacterial conjunctivitis in southern China: a retrospective study

Abstract

Background: Bacterial conjunctivitis is one of the most common ocular problems of neonates. The aim of this study was to retrospectively analyse the clinical and pathogenic characteristics of neonatal bacterial conjunctivitis in southern China from 2017 to 2021. Methods: Clinical and microbiological data of neonates with culture-proven bacterial conjunctivitis in our hospital were retrospectively collected from January 2017 to December 2021. Then, the distribution of the pathogens, the clinical characteristics and the antimicrobial susceptibility patterns were evaluated. Results: Bacteria was separated from 299 samples (30.9%) out of the 967 samples assessed, and 8 patients were infected by two bacteria. A total of 307 pathogens were identified, of which 211 (67.2%) were Gram-positive, and 96 (30.1%) were Gram-negative. S. aureus (53.7%) was the most frequent causative organism, followed by C. macginleyi (10.7%) and E. coli (10.1%). Only one case of N. gonorrhoeae was isolated. An increasing detection rate during the last five years (χ2=16.68, P<0.001) was observed, and a similar trend was found in Gram-positive bacteria (χ2=9.898, P=0.002). Gram-negative bacteria related neonatal conjunctivitis were common among neonates suffered turbid amniotic fluid. Fifty-two S. aureus isolates (34.2%) were methicillin-resistant S. aureus (MRSA) and 5 strains (15.6%) E.coli were extended spectrum b-lactamases (ESBLs) producing bacteria. All S. aureus and C. macginleyi strains are susceptible to vancomycin and linezolid, and E. coli are susceptible to imipenem, ertapenem and amikacin. Conclusion: Although most of neonatal bacterial conjunctivitis are self-limiting disease, investigating the pathogenic characteristics and antibiotics parttern may help to shorten the duration of conjunctival symptoms in neonates with acute bacterial conjunctivitis.