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Objective: The data on neonatal conjunctivitis are significantly limited in Türkiye. In this study, we aimed to investigate the epidemiology of neonatal bacterial conjunctivitis and the clinical and laboratory findings of patients in a tertiary neonatal referral hospital in İstanbul, Türkiye. Methods: This retrospective observational study was conducted over a five-year period between January 2015 and January 2020. Newborns 28 days of age who presented to our clinics with clinical features of conjunctivitis and had bacterial growth in the conjunctival culture were included. Results: Thirty-two newborns with culture-proven bacterial conjunctivitis were included. A total of 26 (81.3%) newborns required newborn intensive care unit (NICU) admission. Gram-positive bacteria growth was detected in 47% (n=15) of cases, and gram-negative growth was detected in 53% (n=17) of cases. Escherichia coli (n=12), Staphylococcus epidermidis (n=10) and Staphylococcus aureus (n=3) were the most frequently identified bacteria. The proportions of newborns with need for intravenous (IV) antibiotic treatment, bilateral eye involvement, and normal spontaneous delivery were significantly higher in the gram-negative conjunctivitis group. Conclusion: Our study provides important data regarding bacterial conjunctivitis in newborns in Türkiye, given that data in Türkiye are very limited. The high rates of NICUs admission, presence of clinical sepsis, and IV antibiotic administration show the importance of neonatal conjunctivitis as a clinical finding of systemic neonatal infections. Despite the lack of universal ocular prophylaxis in our high-volume neonatal referral center, the low number of culture-proven conjunctivitis cases challenges the current routine ocular prophylaxis suggestions. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical and histopathological features of ocular abnormalities noted in a litter of black‐footed ferrets (Mustela nigripes), including corneal opacification, cataracts, persistent pupillary membranes, microphthalmia, symblepharon and anterior segment malformation. Animals Studied: A litter of eight black‐footed ferrets examined at 10 weeks old with a history of ophthalmia neonatorum first noted at 7 days old and histopathological examination of three globes from three ferrets of the same litter between 5 and 7 months old following routine subconjunctival enucleation. Procedures: Due to the fractious nature of black‐footed ferrets, slit‐lamp biomicroscopic examination was performed under general isoflurane anesthesia at 10 weeks of age. Corneal opacification was noted in 9/16 eyes, cataracts in 4/16 eyes, and persistent pupillary membranes in 3/16 eyes, among other findings. Histopathology revealed persistent pupillary membranes and Descemet's membrane abnormalities consistent with congenital anterior segment malformation in all three globes. In one ferret, a posterior cortical cataract with posterior lenticular malformation and lens capsule discontinuity was noted. Purulent discharge was cultured at time of enucleation in one ferret with growth of E. coli. Conclusions: A novel constellation of ocular malformations with primary congenital and secondary to ophthalmia neonatorum etiologies is described in black‐footed ferrets. Due to endangered status of black‐footed ferrets, small genetic pool and the requirement for adequate vision for wild‐release, congenital ocular abnormalities such as anterior segment malformation and likely the cataracts described are of particular concern. Further investigation and monitoring are warranted to determine the heritability of these ocular abnormalities. [ABSTRACT FROM AUTHOR]

Orbital cellulitis is an extremely rare but potentially lethal condition in neonates. The clinical presentation of neonatal orbital cellulitis can be non-specific, and minimal signs of periorbital inflammation may go unrecognised by inexperienced parents or primary care medical personnel, leading to delayed treatment. Herein, we present a case series describing ophthalmia neonatorum complicated with neonatal orbital cellulitis owing to delayed treatment. The clinical presentation, management and outcomes are described. One neonate had orbital cellulitis, while the other had impending orbital cellulitis, with both cases resulting from delayed treatment of ophthalmia neonatorum. Both neonates were hospitalised for systemic antibiotic treatment and fully recovered with good outcomes. Timely identification and treatment of ophthalmia neonatorum are critical to mitigate potential severe sequelae, such as neonatal orbital cellulitis. [ABSTRACT FROM AUTHOR]

There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae. Therefore, there is wide variability in antibiotic administration, conditioned mainly by the social and health context. In Italy, a law enacted in 1940 required doctors and midwives to administer ophthalmic prophylaxis with 2% silver nitrate to all newborns at birth. This law was repealed in 1975 and since then there has been no clear guidance on the use of ophthalmia neonatorum prophylaxis at birth. Since neonatal conjunctivitis caused by C. trachomatis and N. gonorrhoeae is not reported, we carried out a nationwide survey of 1,041,384 neonates across all Italian birth centers to evaluate the incidence of ophthalmia neonatorum and the current practice of prophylaxis. After analyzing the results, we formulated an intersociety position statement on the prevention of ophthalmia neonatorum to update and standardize this prevention strategy in Italy. [ABSTRACT FROM AUTHOR]

Abstract Background Ophthalmia neonatorum is an acute conjunctivitis that occurs in newborns within the first month of life. The most serious infections are due to Chlamydia trachomatis and Neisseria gonorrhoeae, that may cause permanent damages. The use of ophthalmic prophylaxis varies widely around the world, according to the different health and socio-economic contexts. To date in Italy there is no a clear legislation regarding ophthalmia neonatorum prophylaxis at birth. Methods We invited all birth centers in Italy to carry out a retrospective survey relating the last three years. We collected data regarding demographics of neonates, drugs used for ophthalmic prophylaxis and results of the screening of pregnant women for Chlamydia trachomatis and Neisseria gonorrhoeae vaginal infections. Results Among 419 birth centers, 302 (72,1%) responded to the survey. Overall 1041384 neonates, 82,3% of those born in the three years considered, received ophthalmic prophylaxis. Only 4,585 (0,4%) of them received one of the drugs recommended by the WHO. The Centers that participated to the survey reported 12 episodes of Chlamydial conjunctivitis and no Gonococcal infection in the three years. Only 38% of the Centers performed vaginal swabs to pregnant women: 2,6% screened only for Neisseria, 9,6% only for Chlamydia and 25,8% for both germs. Conclusions The data obtained from the survey showed a low incidence of neonatal conjunctivitis due to either Neisseria gonorrhoeae or Chlamydia trachomatis in Italy. Due to the lack of legislation regulating the prophylaxis of ophthalmia neonatorum in newborns, the Italian Society of Neonatology, the Italian Society of Obstetrics and Gynecology and the Italian Society of Perinatal Medicine have recently issued new recommendations on this topic.

Ophthalmia neonatorum (ON) is a form of conjunctivitis occurring within the 1st month of life, primarily attributable to bacterial pathogens. The predominant etiological agents include Chlamydia trachomatis and Neisseria gonorrhoeae. Viral pathogens such as herpes simplex, adenovirus, and enterovirus may also incite ON. Hospital-acquired conjunctivitis (HAC) rarely affects healthy infants who have received prophylactic treatment against ON. Herein, we report a case of ON in a healthy female newborn female caused by Klebsiella pneumoniae. Following the infant’s and her parents’ treatment, the patient’s condition improved, leading to discharge. Strict adherence to infection control protocols, including meticulous hand hygiene practices, is crucial for attenuating this issue and averting the serious complications associated with HAC.

Background: Ophthalmia neonatorum is an acute conjunctivitis that occurs in newborns within the first month of life. The most serious infections are due to Chlamydia trachomatis and Neisseria gonorrhoeae, that may cause permanent damages. The use of ophthalmic prophylaxis varies widely around the world, according to the different health and socio-economic contexts. To date in Italy there is no a clear legislation regarding ophthalmia neonatorum prophylaxis at birth. Methods: We invited all birth centers in Italy to carry out a retrospective survey relating the last three years. We collected data regarding demographics of neonates, drugs used for ophthalmic prophylaxis and results of the screening of pregnant women for Chlamydia trachomatis and Neisseria gonorrhoeae vaginal infections. Results: Among 419 birth centers, 302 (72,1%) responded to the survey. Overall 1041384 neonates, 82,3% of those born in the three years considered, received ophthalmic prophylaxis. Only 4,585 (0,4%) of them received one of the drugs recommended by the WHO. The Centers that participated to the survey reported 12 episodes of Chlamydial conjunctivitis and no Gonococcal infection in the three years. Only 38% of the Centers performed vaginal swabs to pregnant women: 2,6% screened only for Neisseria, 9,6% only for Chlamydia and 25,8% for both germs. Conclusions: The data obtained from the survey showed a low incidence of neonatal conjunctivitis due to either Neisseria gonorrhoeae or Chlamydia trachomatis in Italy. Due to the lack of legislation regulating the prophylaxis of ophthalmia neonatorum in newborns, the Italian Society of Neonatology, the Italian Society of Obstetrics and Gynecology and the Italian Society of Perinatal Medicine have recently issued new recommendations on this topic. [ABSTRACT FROM AUTHOR]

There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae. Therefore, there is wide variability in antibiotic administration, conditioned mainly by the social and health context. In Italy, a law enacted in 1940 required doctors and midwives to administer ophthalmic prophylaxis with 2% silver nitrate to all newborns at birth. This law was repealed in 1975 and since then there has been no clear guidance on the use of ophthalmia neonatorum prophylaxis at birth. Since neonatal conjunctivitis caused by C. trachomatis and N. gonorrhoeae is not reported, we carried out a nationwide survey of 1,041,384 neonates across all Italian birth centers to evaluate the incidence of ophthalmia neonatorum and the current practice of prophylaxis. After analyzing the results, we formulated an intersociety position statement on the prevention of ophthalmia neonatorum to update and standardize this prevention strategy in Italy.

Abstract Ophthalmia neonatorum (ON) refers to any conjunctivitis occurring in the first 28 days of life. In the past Neisseria gonorrhoeae was the most common cause of ON. It decreased with the introduction of prophylaxis at birth with the instillation of silver nitrate 2% (the Credè’s method of prophylaxis). Today, the term ON is used to define any other bacterial infection, in particular due to Chlamydia Trachomatis. Currently, the WHO reccomends topical ocular prophylaxis for prevention of gonococcal and chlamydial conjunctivitis for all neonates. On the contrary, several European countries no longer require universal prophylaxis, opting for screening and treatment of pregnant women at high risk of infection. And what about Italy? Have a look on Italian history of prophylaxis, starting by the first decree issued in 1940, signed by Benito Mussolini. In the following decades the law has undergone many changes. At the moment, legislation is unclear, therefore careful consideration is required in order to draft the correct appoach.

Since the introduction of universal gonococcal and chlamydia prophylaxis, other etiologies for neonatal conjunctivitis such as Escherichia coli have become more common. Early eye culturing as part of the management plan could provide swifter treatment and preservation of vision potential in affected neonates. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the microbiological characteristics and risk factors of severe ophthalmia neonatorum (ON) in Southwest China. Methods: In this retrospective review, data on demography, microbiological results, and risk factors were analyzed. Data were obtained from medical records of patients with severe ON treated at Children's Hospital of Chongqing Medical University from January 2015 to December 2019. To understand the risk factors for severe ON, maternal and neonatal factors were compared between the severe and non-severe ON groups. Results: A total of 1397 neonates with ON were included, of whom 12% (n = 172) had severe ON, and 88% (n = 1225) had non-severe ON. Microbial detection and drug susceptibility tests were performed on 169 patients with severe ON. Culture results were positive for 76 patients, with gram-positive bacteria in 71.1% (n = 54), gram-negative bacteria in 25.0% (n = 19), and multiple microorganisms in 3.9% (n = 3) neonates. The most commonly detected organisms were Staphylococcus aureus (29%) and Staph. epidermis (27%), followed by Escherichia coli (8%). Neisseria gonorrhea (8%), Moraxella catarrhal (5%), Streptococcus pneumoniae (4%), Haemophilus influenza (4%), and Chlamydia trachomatis (1%). The main risk factors for severe ON were obstruction of the nasolacrimal duct (χ2 = 10.794, P = 0.001), meconium aspiration syndrome (χ2 = 6.252, P = 0.012), and cesarian section (χ2 = 5.118, P = 0.024). Neonatal ocular prophylaxis was a protective factor for severe conjunctivitis (χ2 = 6.905, P = 0.009). Conclusions: Staphylococcus is the most common pathogen of severe ON. Nasolacrimal duct obstruction (NLDO) is a risk factor for ON. [ABSTRACT FROM AUTHOR]

Abstract Since the introduction of universal gonococcal and chlamydia prophylaxis, other etiologies for neonatal conjunctivitis such as Escherichia coli have become more common. Early eye culturing as part of the management plan could provide swifter treatment and preservation of vision potential in affected neonates.

Ophthalmia neonatorum (ON) refers to any conjunctivitis occurring in the first 28 days of life. In the past Neisseria gonorrhoeae was the most common cause of ON. It decreased with the introduction of prophylaxis at birth with the instillation of silver nitrate 2% (the Credè's method of prophylaxis). Today, the term ON is used to define any other bacterial infection, in particular due to Chlamydia Trachomatis. Currently, the WHO reccomends topical ocular prophylaxis for prevention of gonococcal and chlamydial conjunctivitis for all neonates. On the contrary, several European countries no longer require universal prophylaxis, opting for screening and treatment of pregnant women at high risk of infection. And what about Italy? Have a look on Italian history of prophylaxis, starting by the first decree issued in 1940, signed by Benito Mussolini. In the following decades the law has undergone many changes. At the moment, legislation is unclear, therefore careful consideration is required in order to draft the correct appoach. [ABSTRACT FROM AUTHOR]

Background: Conjunctivitis is a common infection among neonates and it is a known cause of preventable childhood blindness. There is geographical variation in the distribution of aetiological agents. Objective: To assess the prevalence of conjunctivitis among hospitalized neonates receiving care in a tertiary health care centre in South-west Nigeria, and describe its clinical and bacteriological correlates. Methods: The hospital records of neonates diagnosed with conjunctivitis at the Olabisi Onabanjo University Teaching Hospital, Sagamu between January 2015 and December 2019 were reviewed. Their bio-data, perinatal history, laboratory results and treatment received were extracted for analysis. Results: One hundred and twenty-two neonates had conjunctivitis out of a total number of 2,286 admissions, giving a prevalence rate of 5.3%. Male infants had almost double the risk of developing the disease compared to female infants (OR = 1.6; 95% CI: 1.09-2.35). Eighty-six (70.5%) babies were term, while 21 (17.2%) and 15 (12.3%) were preterm and small-for-gestational-age respectively. Most cases of neonatal conjunctivitis (82.0%) occurred in the first week of life while the mean ±SD age of onset was 5.3±4.5 days. Staphylococcus aureus and Klebsiella species were the commonest bacterial isolates affecting 57.1% and 23.0% neonates respectively. Moderately-high rates of resistance to erythromycin and gentamicin were observed among the bacterial isolates. Conclusion: Neonatal conjunctivitis is commonly due to Staphylococcus aureus and Klebsiella species in this setting. It is commoner among male infants. Most cases run a mild course with good response to topical antimicrobial therapy.

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.

Health education is key in the prevention of Ophthalmia Neonatorum (ON). However, health education in relation to eye care in Ghana is very low. To determine the knowledge, attitudes and practices (KAPs) of mothers on Ophthalmia Neonatorum (eye infection in newborns), a descriptive cross-sectional design was adopted, using a standardised interviewer-administered questionnaire to collect data. Using a consecutive sampling technique, we enrolled 407 mothers to participate in the study. The overall KAPs of the study participants were assessed using the sum score of each outcome based on Bloom's cut-off point. Completed data was then analysed using descriptive statistics with SPSS version 22.0 at the level of P <.05. Out of the 407 participants, 321 (78.9%) had not heard about Ophthalmia Neonatorum with nearly 93% having low levels of knowledge on the neonatal infection. We found a significant association between formal education (P =.001), skilled occupation (P =.008) and a high level of knowledge on Ophthalmia Neonatorum. The study highlights the need to find improved and alternative methods of educating mothers on Ophthalmia Neonatorum in the bid to reduce blindness attributed to the condition. [ABSTRACT FROM AUTHOR]

Neonatal conjunctivitis is a worldwide problem. Although global incidence is not known, incidents of 1-24% have been reported from various regions of the world especially those practicing home delivery without standard prophylaxis. This study was an in-vitro investigation on possible prophylaxis for ophthalmia neonatorum (ON) like potassium aluminum sulfate (KAlSO4)2 and povidone iodine (C6H9I2NO) in comparison to tetracycline. A five by three (5x3) factorial experiment in Completely Randomized Design (CRD) was used in this study. Factor A was the five-test bacteria, namely Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterobacter spp. and Pseudomonas spp. while Factor B was the experimental variables or the substances to be tested such as alum, povidone iodine and tetracycline. Aluminum was diluted and subjected to purity test prior to bacteria assay. The zone of inhibition was measured using a caliper and results were recorded. Based on the in-vitro analysis, aluminum showed a positive response to the five tested bacteria as it yielded a comparative mean results of growth inhibition. Among the possible applications of the findings in the study could be the formulation of antiseptic eye drops with the use of alum or Povidone iodine to be used as prophylaxis to guard against neonatal conjunctivitis.

A retrospective 5-year province-wide evaluation of prenatal Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) screening in Alberta, Canada, was carried out to assess compliance with the provincial recommendations for universal prenatal screening as a prevention for neonatal ophthalmia. Screening generally improved across the province each year, 82.1% in 2018 and reaching 87.3% in 2022. Women in the age group under 25 years were the most likely to not have the recommended first-trimester screening and demonstrated the highest prevalence of GC and CT infections. The results of this investigation demonstrate that continued improvements are needed to achieve universal prenatal GC/CT screening in Alberta., (Copyright © 2023 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. All rights reserved.)

There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae . Therefore, there is wide variability in antibiotic administration, conditioned mainly by the social and health context. In Italy, a law enacted in 1940 required doctors and midwives to administer ophthalmic prophylaxis with 2% silver nitrate to all newborns at birth. This law was repealed in 1975 and since then there has been no clear guidance on the use of ophthalmia neonatorum prophylaxis at birth. Since neonatal conjunctivitis caused by C. trachomatis and N. gonorrhoeae is not reported, we carried out a nationwide survey of 1,041,384 neonates across all Italian birth centers to evaluate the incidence of ophthalmia neonatorum and the current practice of prophylaxis. After analyzing the results, we formulated an intersociety position statement on the prevention of ophthalmia neonatorum to update and standardize this prevention strategy in Italy.

• 78 million new infections annually; greatest impact on women and neonates in LMIC. • Current control measures are inadequate and challenged by antibiotic resistance. • Conserved candidate vaccine antigens and adjuvant strategies are being developed. • There is a need for human studies to investigate correlates of immunity. • A meningococcal outer membrane vesicle vaccine may protect against gonorrhea. There is a growing public health interest in controlling sexually transmitted infections (STIs) through vaccination due to increasing recognition of the global disease burden of STIs and the role of STIs in women's reproductive health, adverse pregnancy outcomes, and the health and well-being of neonates. Neisseria gonorrhoeae has historically challenged vaccine development through the expression of phase and antigenically variable surface molecules and its capacity to cause repeated infections without inducing protective immunity. An estimated 78 million new N. gonorrhoeae infections occur annually and the greatest disease burden is carried by low- and middle-income countries (LMIC). Current control measures are clearly inadequate and threatened by the rapid emergence of antibiotic resistance. The gonococcus now holds the status of "super-bug" as there is currently no single reliable monotherapy for empirical treatment of gonorrhea. The problem of antibiotic resistance has elevated treatment costs and necessitated the establishment of large surveillance programs to track the spread of resistant strains. Here we review the need for a gonorrhea vaccine with respect to global disease burden and related socioeconomic and treatment costs, with an emphasis on the impact of gonorrhea on women and newborns. We also highlight the challenge of estimating the impact of a gonorrhea vaccine due to the need for more data on the burden of gonococcal pelvic inflammatory disease and related sequelae and of gonorrhea-associated adverse pregnancy outcomes and the problem of empirical diagnosis and treatment of STIs in LMIC. There is also a lack of clinical and basic science research in the area of gonococcal/chlamydia coinfection, which occurs in a high percentage of individuals with gonorrhea and should be considered when testing the efficacy of gonorrhea vaccines. Finally, we review recent research that suggests a gonorrhea vaccine is feasible and discuss challenges and research gaps in gonorrhea vaccine development. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The bacterial species Neisseria gonorrhoeae (N. gonorrhoeae) and Staphylococcus aureus (S. aureus) are amongst the main microorganisms that cause ophthalmia neonatorum. The current treatment involves the use of various antibiotics such as ciprofloxacin, cephalosporin, ceftriaxone and cefotaxime. However, this treatment strategy is becoming more ineffective due to the antibiotic resistance in N. gonorrhoeae. The current study explores the potential use of fatty acid based microemulsions (ME) to prevent N. gonorrhoeae and S. aureus infections in new-borns' eyes without harmful side effects such as corneal or conjunctiva irritation. Pseudo-ternary phase diagrams were constructed to evaluate microemulsion regions and six different α-linolenic acid based microemulsions were prepared. The prepared formulations were characterized for α-linolenic acid content, size, transparency, zeta potential, Polarized light Microscopy, antimicrobial activity and ex vivo ocular toxicity. The mean droplet size of the ME formulations was in the range of 190.4 to 350.5 nm and polydispersity index (PDI) values were in the range of 0.102 to 0.561. All formulations were found stable upon storage for at least 8 weeks. In addition, self-diffusion coefficients determined by nuclear magnetic resonance (NMR) reflected that the diffusability of water increased at higher than 30% w/w water, while that of fatty acids and surfactants was in reverse. The antimicrobial efficacy of microemulsions was determined against N. gonorrhoeae and S. aureus. It was concluded that all microemulsions have strong antimicrobial effects against N. gonorrhoeae and S. aureus. Finally, bovine corneal opacity permeability (BCOP) and hen's egg chorioallantoic (HET-CAM) tests results showed that all microemulsion formulations were not strong ocular irritants. [ABSTRACT FROM AUTHOR]

Extraocular infection is a frequently encountered problem in children including neonates and infants. Prompt recognition of the extraocular disease and management at first contact reduces the ocular morbidity and visual impairment. Delay in administering appropriate therapy and referral to an eye care personnel may result in blindness; sometimes bilateral, due to severe ophthalmia neonatorum. This review is mainly aimed at offering basic, brief information about common extraocular infections prevalent among infants and children living in developing countries as a ready reference to practising pediatricians and neonatologists. Through this review, the pediatricians, as the first contact may feel confident and comfortable in managing ocular infection in pediatric population particularly living in remote rural and tribal region. Literature search was made by retrieving related publications through peer reviewed journals, PUBMED and Cochrane meta-analysis. [ABSTRACT FROM AUTHOR]

Neisseria gonorrhoeae es una causa importante de oftalmía neonatal, pudiendo causar múltiples complicaciones en el recién nacido, incluyendo perforación corneal, panoftalmitis y ceguera. Se presenta caso de recién nacido de 1 mes de vida, con conjuntivitis infecciosa bilateral y compromiso corneal unilateral, además de cultivo positivo para gonococo. TAC mostró compromiso inflamatorio intraocular del ojo izquierdo. Se manejó con terapia antibiótica endovenosa, evolucionando con opacificación, vascularización, adelgazamiento progresivo de la córnea y atalamia del ojo izquierdo. Se sometió a cirugía para parche corneal y reformación de cámara anterior. Durante seguimiento, ecografía ocular mostró un examen normal del ojo derecho y una menor longitud axial y engrosamiento coroideo del ojo izquierdo.

We report a case of a 3-day-old boy with Neisseria cinerea conjunctivitis, originally misidentified as Neisseria gonorrhoeae conjunctivitis. Neonates are at increased risk for disseminated gonococcal infection, and physicians should be cognizant of N cinerea and its potential to be mistaken for N gonorrhoeae. [ABSTRACT FROM AUTHOR]

Ophthalmia neonatorum can cause corneal perforation and intraocular infection.

Antibiotic-resistant gonorrhea is now a reality, as well as the consequences of untreatable infections. Gonococcal eye infections result in blindness if not properly treated; they accounted for the vast majority of infections in children in homes for the blind in the pre-antibiotic era. Neisseria gonorrhoeae infects the eyes of infants born to mothers with gonorrhea and can also infect the eyes of adults. Changes in sexual practices may account for the rise in adult gonococcal eye infections, although some cases seem to have occurred with no associated genital infection. As gonorrhea becomes increasingly difficult to treat, the consequences for the treatment of gonococcal blindness must be considered as well. Monocaprin was shown to be effective in rapidly killing N. gonorrhoeae, and is non-irritating in ocular models. Repeated passage in sub-lethal monocaprin induces neither resistance in gonococci nor genomic mutations that are suggestive of resistance. Here, we show that 1 mM monocaprin kills 100% of N. gonorrhoeae in 2 min, and is equally effective against N. meningitidis, a rare cause of ophthalmia neonatorum that is potentially lethal. Monocaprin at 1 mM also completely kills Staphylococcus aureus after 60 min, and 25 mM kills 80% of Pseudomonas aeruginosa after 360 min. Previously, 1 mM monocaprin was shown to eliminate Chlamydia trachomatis in 5 min. Monocaprin is, therefore, a promising active ingredient in the treatment and prophylaxis of keratitis, especially considering the growing threat of gonococcal blindness due to antimicrobial resistance.

The bacterial species Neisseria gonorrhoeae (N. gonorrhoeae) and Staphylococcus aureus (S. aureus) are amongst the main microorganisms that cause ophthalmia neonatorum. The current treatment involves the use of various antibiotics such as ciprofloxacin, cephalosporin, ceftriaxone and cefotaxime. However, this treatment strategy is becoming more ineffective due to the antibiotic resistance in N. gonorrhoeae. The current study explores the potential use of fatty acid based microemulsions (ME) to prevent N. gonorrhoeae and S. aureus infections in new-borns’ eyes without harmful side effects such as corneal or conjunctiva irritation. Pseudo-ternary phase diagrams were constructed to evaluate microemulsion regions and six different α-linolenic acid based microemulsions were prepared. The prepared formulations were characterized for α-linolenic acid content, size, transparency, zeta potential, Polarized light Microscopy, antimicrobial activity and ex vivo ocular toxicity. The mean droplet size of the ME formulations was in the range of 190.4 to 350.5 nm and polydispersity index (PDI) values were in the range of 0.102 to 0.561. All formulations were found stable upon storage for at least 8 weeks. In addition, self-diffusion coefficients determined by nuclear magnetic resonance (NMR) reflected that the diffusability of water increased at higher than 30% w/w water, while that of fatty acids and surfactants was in reverse. The antimicrobial efficacy of microemulsions was determined against N. gonorrhoeae and S. aureus. It was concluded that all microemulsions have strong antimicrobial effects against N. gonorrhoeae and S. aureus. Finally, bovine corneal opacity permeability (BCOP) and hen’s egg chorioallantoic (HET-CAM) tests results showed that all microemulsion formulations were not strong ocular irritants.

OBJETIVOS: Avaliar a aplicabilidade da profilaxia da oftalmia neonatal em cinco serviços de obstetrícia de maternidades da Grande Florianópolis no período de março de 2007. MÉTODOS: Cinco serviços de obstetrícia de maternidades da Grande Florianópolis foram visitados e questionados quanto ao método realizado na prevenção da ON, o custo por unidade de colírio utilizado, o conhecimento do método de Credé e a legislação vigente. RESULTADOS: As soluções profiláticas utilizadas foram a iodopovidona a 2,5% e o vitelinato de prata a 10%. O uso do vitelinato de prata a 10% foi predominante entre os serviços analisados (60%) e também o de menor custo (de R$ 5,26 a R$ 7,23 por frasco de 5ml), quando comparado a iodopovidona a 2,5% que apresentou custo de R$ 15,00 por frasco de 5 ml e R$ 25,40 por frasco de 10 ml. Entre os entrevistados, apenas um tinha conhecimento sobre a legislação vigente acerca da aplicabilidade da profilaxia da oftalmia neonatal. CONCLUSÃO: A aplicabilidade da profilaxia neonatal na maioria dos serviços de obstetrícia das maternidades da Grande Florianópolis é realizada de maneira incorreta e não está em concordância com a legislação vigente.OBJECTIVE: To evaluate the applicability of the ophthalmia neonatorum prophylaxis in five maternities obstetric services of Greater Florianopolis, Brazil; during march 2007. METHODS: Five maternities obstetric services of Greater Florianopolis were visited and questioned about the method carried through in the prevention of the ON, the cost for unit of used eye drops unit, the knowledge of the Credé method and the current legislation. RESULTS: The prophylactic solutions used were povidone-iodine 2.5% and silver vitelinate 10%. The use of silver vitelinate 10% was predominant in the analyzed services (60%) and also of lower cost (from R$ 5,26 to R$ 7,23 for bottle of 5 ml) when compared with povidone-iodine 2.5% that had cost of R$ 15,00 the 5 ml bottle and R$ 25,40 the 10 ml bottle. Among interviewees only one had knowledge on the current legislation concerning the applicability of the prophylaxis of the ophthalmia neonatorum. CONCLUSIONS: The applicability of the neonatal prophylaxis in the majority of the maternities obstetric services of Greater Florianopolis is carried through incorrect way and it is not in agreement with the current legislation.

Ophthalmia neonatorum remains a significant cause of ocular morbidity, blindness and even death in underdeveloped countries. The organisms causing ophthalmia neonatorum are acquired mainly from the mother’s birth canal during delivery and a small percentage of cases are acquired by other ways. Chlamydia and Neisseria are the most common pathogens responsible for the perinatal infection. Fortunately in most cases, laboratory studies can identify the causative organism and unlike other form of conjunctivitis, this perinatal ocular infection has to be treated with systemic antibiotics to prevent systemic colonization of the organism. Routine prophylaxis with 1% silver nitrate solution (crédés method) has been discontinued in many developed nations for the fear of development of chemical conjunctivitis.

Introduction: Characteristics of ophthalmia neonatorum (ON) amongst paediatric ophthalmologists remain unclear. The purpose of this current study is to examine the incidence, diagnosis, treatment, and prophylaxis of ON cases presenting to members of the American Association of Paediatric Ophthalmology and Strabismus (AAPOS). Methods: An email containing a web link to a survey was sent to all members of AAPOS. The questionnaire examined the incidence of ON, etiology, diagnostic methods, treatment, and prophylaxis of the disease in different countries around the world. Results: Two hundred and ninety-one ophthalmologists answered the questionnaire. Most were from North America (52.94 %). One hundred and seventy-six (60.69 %) ophthalmologists encountered 0-5 cases of ON per year. The most common pathogens causing ON was Chlamydia trachomatis (35.37 %). Two hundred and forty-two (85.21 %) treat empirically when encountering ON during the first 10 days of life and 205 (75.09 %) after the first 10 days of life. In both cases, erythromycin was the most common first line of treatment. Two hundred and twenty-two (78.72 %) ophthalmologists replied that prophylactic treatment is required in their country. The most common agent for prophylaxis was erythromycin ointment (71.50 %). Conclusions: We found that the incidence of ON per year per practitioner is 0-5 cases, the most common etiology is C. trachomatis, and most infants receive prophylaxis and treatment. [ABSTRACT FROM AUTHOR]

Paediatric patients make up a significant portion of the patient load at primary care level. Children can present at the primary care physician with a wide range of eye problems, some of which are serious enough to impair the quality of the child’s life. The aim of this review article was to highlight serious paediatric visual disorders of which the primary care practitioner should be aware. The article includes a brief discussion of the features of amblyopia, strabismus, retinopathy of prematurity, allergic conjunctivitis, ophthalmia neonatorum and retinoblastoma. Causes of sight-threatening conditions are highlighted, and methods to detect them at primary care level described. Paediatric eye disorders are relatively common and need to be identified and managed as early as possible in order to prevent a potential lifetime of visual morbidity, blindness or worse. [ABSTRACT FROM PUBLISHER]

Context: Neonatal conjunctivitis is associated with poor prenatal care worldwide. Purpose: Data on neonatal conjunctivitis is scarce in Malawi. This study describes risk factors associated with conjunctivitis in neonates born in a large tertiary care hospital in Blantyre, Malawi. Materials and Methods: Medical records of a retrospective cohort of 231 neonates diagnosed with conjunctivitis from January 2006 to December 2009 at a large tertiary hospital in Malawi were reviewed. All subjects were clinically diagnosed with ophthalmia neonatorum. Data were collected on patient demographics and clinical features. The frequencies were calculated of various risk factors in neonates with ophthalmia neonatorum and their mothers as well as the treatments administered. Results: Mean age of the mother was 23.45 years (range, 15-40 years), and the mean number of previous deliveries was 2.3 (range, 1-7) children. Nearly, 80% of mothers delivered preterm infants via spontaneous vaginal delivery. The mean birth weight of neonates was 2869.6 grams (1100-5000 grams). Among mothers, premature rupture of membranes was the leading risk factor (24%) followed by sepsis during labor (9%), and history of sexually transmitted infections (STI) (7%). Neonates presented with low Apgar scores (19%), fever (8%), and/or meconium aspiration (5%). Providers treated patients empirically with a varied combination of benzyl penicillin, gentamicin, tetracycline eye ointment, and saline eye wash. Tetracycline with a saline eyewash was used frequently (34%) compared with combinations of benzyl penicillin and gentamicin. Conclusions: Improving prenatal care to reduce sepsis, traumatic deliveries, and early diagnosis of STI with appropriate treatment may potentially reduce vertical transmission of neonatal conjunctivitis in this understudied population. [ABSTRACT FROM AUTHOR]

Ophthalmia neonatorum, a form of neonatal conjunctivitis, was seen to be a serious problem in England at the turn of the twentieth century. Midwives were directly implicated in its prevalence with debate ensuing over the extent to which they should be taught about ophthalmia neonatorum and the extent to which they should participate in the diagnostic and therapeutic process. The involvement of midwives in cases of ophthalmia neonatorum has received little attention from historians. Yet it constitutes an important case study for the limitations in theoretical knowledge available to midwives, and for the professional and disciplinary boundaries imposed upon midwifery practice following the passing of the Midwives Act in 1902 and the establishment of the Central Midwives Board. This article addresses the training of midwives in ophthalmia neonatorum and the ways in which midwives were able to utilise such training in their professional practice. [ABSTRACT FROM PUBLISHER]

Neonatal Conjunctivitis, also known as Ophthalmia Neonatorum, is a form of bacterial conjunctivitis contracted by newborn during delivery. It is a rare clinical entity in advanced countries, but relatively common in developing countries. Many bacteria and viruses can cause conjunctivitis in the neonates. Two most feared causes are Neisseria gonorrhoeae and Chlamydia trachomatis acquired from birth canal during delivery. We present a case of gonococcal Ophthalmia Neonatorum in a 20 days young neonate from mid-western (Myagdi), Nepal.

One of the most common bacterial infections that causes ophthalmia neonatorum is Chlamydia trachomatis, (C. trachomatis). Very few studies have been performed in Iran using both cell culture and polymerase chain reaction (PCR) methods to determine the prevalence of C. trachomatis as an etiological agent of ophthalmia neonatorum. This study aimed to evaluate the prevalence of neonatal chlamydial conjunctivitis (NCC) as diagnosed by both methods in two hospitals in Tehran, Iran. From March 2008 to May 2009, out of 2253 neonates, 241 (10.7%) with clinical findings of conjunctivitis were included in this study. A total of 241 conjunctival swabs were tested by cell culture (as the gold standard test), PCR, and Giemsa staining. Cell cultures were positive for C. trachomatis m 31 (12.9%) neonates, C. trachomatis was positive in 40 (16.6%) neonates by PCR and (7.5%) by Giemsa staining. The sensitivity of PCR was 100%, whereas Giemsa staining sensitivity was 58.1%. High sensitivity (100%) and specificity (95.7%) of PCR as compared to culture makes it a proper diagnostic method for the detection C. trachomatis. [ABSTRACT FROM AUTHOR]