RESUMEN
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.
Asunto(s)
Infecciones por Chlamydia/epidemiología , Conjuntivitis de Inclusión/epidemiología , Gonorrea/epidemiología , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Oftalmía Neonatal/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Infecciones por Chlamydia/congénito , Infecciones por Chlamydia/transmisión , Conjuntivitis de Inclusión/congénito , Conjuntivitis de Inclusión/microbiología , Conjuntivitis de Inclusión/prevención & control , Femenino , Gonorrea/congénito , Gonorrea/transmisión , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Masculino , Tamizaje Masivo , Técnicas de Amplificación de Ácido Nucleico , Oftalmía Neonatal/microbiología , Oftalmía Neonatal/prevención & control , Vigilancia de la Población , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Prevalencia , Estados Unidos/epidemiologíaRESUMEN
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.
Asunto(s)
Chlamydia trachomatis , Conjuntivitis de Inclusión/congénito , Antibacterianos/uso terapéutico , Conjuntivitis de Inclusión/diagnóstico , Conjuntivitis de Inclusión/tratamiento farmacológico , Conjuntivitis de Inclusión/epidemiología , Diagnóstico Diferencial , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Recién Nacido , Macrólidos , Tamizaje Masivo/métodos , Reacción en Cadena de la Polimerasa , Embarazo , Prevalencia , Prevención Primaria/métodosRESUMEN
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.
Asunto(s)
Infecciones Bacterianas/epidemiología , Conjuntivitis de Inclusión/epidemiología , Neumonía/epidemiología , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/aislamiento & purificación , Infecciones Bacterianas/congénito , Estudios de Casos y Controles , Conjuntivitis de Inclusión/congénito , Humanos , Incidencia , Recién Nacido , Modelos Logísticos , Nueva Zelanda/epidemiología , Oportunidad Relativa , Neumonía/congénito , Factores de Riesgo , Infecciones Estreptocócicas/congénitoRESUMEN
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%).
Asunto(s)
Conjuntivitis de Inclusión/epidemiología , Oftalmía Neonatal/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Conjuntivitis de Inclusión/congénito , Gambia , Humanos , Recién Nacido , Neisseria gonorrhoeae/aislamiento & purificación , Oftalmía Neonatal/etiología , Estudios ProspectivosAsunto(s)
Infecciones por Chlamydia/diagnóstico , Chlamydia/clasificación , Chlamydia/crecimiento & desarrollo , Chlamydia/aislamiento & purificación , Infecciones por Chlamydia/congénito , Infecciones por Chlamydia/microbiología , Conjuntivitis de Inclusión/congénito , Conjuntivitis de Inclusión/diagnóstico , Conjuntivitis de Inclusión/microbiología , Femenino , Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Femeninos/microbiología , Enfermedades de los Genitales Masculinos/diagnóstico , Enfermedades de los Genitales Masculinos/microbiología , Humanos , Recién Nacido , Masculino , Neumonía/congénito , Neumonía/diagnóstico , Neumonía/microbiología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/microbiología , Pruebas Serológicas/métodosRESUMEN
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.