ABSTRACT
Perinatal transmission of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) can result in conjunctivitis in infants. We examined national rates of reported CT/GC conjunctivitis among infants. Surveillance of these infections is heavily affected by the completeness of reported data on specimen source and age. Alternative data sources should be evaluated.
Subject(s)
Chlamydia Infections/epidemiology , Conjunctivitis, Inclusion/epidemiology , Gonorrhea/epidemiology , Infectious Disease Transmission, Vertical/statistics & numerical data , Ophthalmia Neonatorum/epidemiology , Pregnancy Complications, Infectious/epidemiology , Chlamydia Infections/congenital , Chlamydia Infections/transmission , Conjunctivitis, Inclusion/congenital , Conjunctivitis, Inclusion/microbiology , Conjunctivitis, Inclusion/prevention & control , Female , Gonorrhea/congenital , Gonorrhea/transmission , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Male , Mass Screening , Nucleic Acid Amplification Techniques , Ophthalmia Neonatorum/microbiology , Ophthalmia Neonatorum/prevention & control , Population Surveillance , Pregnancy , Pregnancy Complications, Infectious/microbiology , Prevalence , United States/epidemiologyABSTRACT
Infections of the conjunctiva are frequent in the neonatal period. While Neisseria gonorrhoea and chemical agents were considered as the main etiologies of ophtalmiae neonatorum in the past, Chlamydia trachomatis is today a major cause of neonatal conjunctivitis. Thus in a study of 180 uni-or bilateral neonatal conjunctivitis the authors found a prevalence of Chlamydia trachomatis infection of 41%. The importance of the etiological diagnosis of neonatal conjunctivitis is emphasized, in order to define a specific treatment. Etiological diagnosis of Chlamydia trachomatis infection is based upon immunofluorescence and molecular diagnosis techniques (PCR, LCR). Prevention of neonatal Chlamydia trachomatis conjunctivitis relies upon screening and treatment of Chlamydia trachomatis infections in pregnant women and their partners. Treatment requires oral macrolides, the topical treatment being ineffective.
Subject(s)
Chlamydia trachomatis , Conjunctivitis, Inclusion/congenital , Anti-Bacterial Agents/therapeutic use , Conjunctivitis, Inclusion/diagnosis , Conjunctivitis, Inclusion/drug therapy , Conjunctivitis, Inclusion/epidemiology , Diagnosis, Differential , Female , Fluorescent Antibody Technique , Humans , Infant, Newborn , Macrolides , Mass Screening/methods , Polymerase Chain Reaction , Pregnancy , Prevalence , Primary Prevention/methodsABSTRACT
A retrospective case-control study was designed to assess risk factors for neonatal infection. Nonprivate patients (8,215) who delivered in a period from January 1, 1983 to June 30, 1988 were studied. Ninety three cases of conjunctivitis (incidence 2.4/1,000), 104 cases of pneumonia (incidence 2.8/1,000), and 50 cases of sepsis (incidence 1.3/1,000) were identified. Group B streptococcus was cultured from septic neonates in 46%. Calculated Odds ratio's indicated prematurity/low birth-weight (OR 6.9) and antepartum fetal tachycardia (OR 6.3) as important risk factors for pneumonia/sepsis. Prematurity/low birth-weight (OR 3.0) and an abnormal presentation in the birth canal (OR 2.8) were identified as risk factors for conjunctivitis. After testing all the risk factors found by univariate analysis in a logistic regression model tachycardia (chi 2 35.21, p less than 0.001) remained an independent predictor for neonatal pneumonia/sepsis and abnormal vaginal presentation (chi 2 7.58, p 0.006) for conjunctivitis.
Subject(s)
Bacterial Infections/epidemiology , Conjunctivitis, Inclusion/epidemiology , Pneumonia/epidemiology , Streptococcal Infections/epidemiology , Streptococcus agalactiae/isolation & purification , Bacterial Infections/congenital , Case-Control Studies , Conjunctivitis, Inclusion/congenital , Humans , Incidence , Infant, Newborn , Logistic Models , New Zealand/epidemiology , Odds Ratio , Pneumonia/congenital , Risk Factors , Streptococcal Infections/congenitalABSTRACT
Swabs were taken for isolation of Chlamydia trachomatis and Neisseria gonorrhoeae from 112 infants with ophthalmia neonatorum attending a hospital in The Gambia. C. trachomatis was isolated from 37 (33%) and N. gonorrhoeae from 28 (25%), with both organisms being present in three cases (3%). A prospective study of 335 neonates was also undertaken in a Gambian town. Fifty-five infants (16%) showed clinical evidence of ophthalmia neonatorum. C. trachomatis was isolated from nine of these (16%) and N. gonorrhoeae from seven (13%).
Subject(s)
Conjunctivitis, Inclusion/epidemiology , Ophthalmia Neonatorum/epidemiology , Chlamydia trachomatis/isolation & purification , Conjunctivitis, Inclusion/congenital , Gambia , Humans , Infant, Newborn , Neisseria gonorrhoeae/isolation & purification , Ophthalmia Neonatorum/etiology , Prospective StudiesSubject(s)
Conjunctivitis, Inclusion/diagnosis , Child , Chronic Disease , Conjunctivitis, Inclusion/congenital , Female , HumansSubject(s)
Chlamydia Infections/diagnosis , Chlamydia/classification , Chlamydia/growth & development , Chlamydia/isolation & purification , Chlamydia Infections/congenital , Chlamydia Infections/microbiology , Conjunctivitis, Inclusion/congenital , Conjunctivitis, Inclusion/diagnosis , Conjunctivitis, Inclusion/microbiology , Female , Genital Diseases, Female/diagnosis , Genital Diseases, Female/microbiology , Genital Diseases, Male/diagnosis , Genital Diseases, Male/microbiology , Humans , Infant, Newborn , Male , Pneumonia/congenital , Pneumonia/diagnosis , Pneumonia/microbiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/microbiology , Serologic Tests/methodsABSTRACT
A method for rapid identification of Chlamydia trachomatis (C. trachomatis) from clinical specimens using fluorescein-conjugated monoclonal antibodies was evaluated. Attempts to isolate C. trachomatis by McCoy cell cultures were simultaneously performed. C. trachomatis was isolated from 8 of 62 newborns with neonatal conjunctivitis in tissue culture as compared with 12 positives using monoclonal antibodies. C. trachomatis was isolated from 2 of 7 infants with pneumonia in tissue cultures as compared with 3 positives using monoclonal antibodies. In order to identify either elementary bodies (EB) or reticulate bodies (RB) in clinical specimens, EB and RB of C. trachomatis L2/434 strain were isolated, purified and reacted with monoclonal antibodies. Majority of fluorescence observed in the clinical specimens was considered to be EB.
