Pathogenic bacteria and their antibiotic sensitivity in ophthalmia neonatorum

Abstract

CONTEXT: Emergence of coagulase-negative staphylococci as pathogens in ophthalmia neonatorum. AIMS: To analyze the bacteriological spectrum of ophthalmia neonatorum and its associated risk factors. SETTINGS AND DESIGN: Retrospective analysis in a tertiary care hospital in India. SUBJECTS AND METHODS: A retrospective review was performed in a tertiary care center in India on 139 neonates presenting with conjunctivitis over a period of 3 years. All the neonates presenting to the out-patient department, those admitted in the Neonatal Intensive care Unit and in-patient wards were included in our study. The neonates were clinically examined and followed-up by a single experienced ophthalmologist. Details including demographic data, age of the infant, type of delivery, investigations, and treatment outcomes were analyzed. STATISTICAL ANALYSIS USED: Frequency calculation using Microsoft Excel for windows 10. RESULTS: In the 92 samples with growth (66.2%), the most common organisms isolated were coagulase-negative Staphylococci (35.9%), Klebsiella pneumoniae (16.3%), and Acinetobacter species (16.3%). Others were Staphylococcus aureus (14.1%), Pseudomonas aeruginosa (8.7%), and Escherichia coli (8.7%). Ophthalmia neonatorum was significantly higher in preterm infants born out of lower-segment cesarean section and those requiring ventilatory support. CONCLUSIONS: Unlike gonococcus, which is implicated in ophthalmia neonatorum, our study shows varied microbiological spectrum and sensitivity patterns with coagulase-negative staphylococci as the key pathogen. The role of coagulase-negative staphylococci as a disease-causing pathogen becomes increasingly important with an imperative need for prudent use of common antibiotics in treating these pathogenic bacteria.

Respuesta al caso clínico: abordaje de conjuntivitis en recién nacido1

“…De las causas bacterianas, Chlamydia trachomatis es la más común, seguida de Neisseria gonorrhoeae como una de las causas de infección grave que requiere un rápido diagnóstico y tratamiento; con menor frecuencia se han descrito otras etiologías como Staphylococcus aureus, Pseudomonas aeruginosa y Virus del herpes simple (VHS). [1][2][3] La ON gonocócica es una infección que se transmite por el paso del producto por el canal vaginal de una gestante infectada por N. gonorrhoeae. Esta infección tiene una incidencia menor a 1% a nivel mundial.…”

“…La ON gonocócica se desarrolla en 30-40% de los recién nacidos expuestos durante el nacimiento y que no reciben profilaxis oftálmica adecuada después del parto. 3 El periodo de incubación es de tres a cinco días. 6 Para el diagnóstico, se debe tomar muestra con un hisopo de dacrón o rayón estériles, posteriormente se debe sembrar en agar chocolate donde se identificará crecimiento aproximadamente a las 48 horas.…”