Conjunctival bacterial infection among hospitalized neonates

Abstract

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.