Prevalence and etiology of neonatal conjunctivitis in neonates hospitalized in Imam Khomeini hospital, Tehran

Background: The purpose of the present study was to identify the prevalence of neonatal conjunctivitis and its bacteriological causes in neonates hospitalized in Imam Khomeini and Vali-e-Asr hospitals during 5 years and to investigate the maternal and newborns' data in conjunctivitis cases.
Methods: All newborns born in or referred to the two above-mentioned hospitals being clinically suspicious of conjunctivitis and with positive microbiology were studied.
Findings: Of 4021 neonates hospitalized in the two hospitals, 198 (4.9%) had conjunctivitis. 65% of conjunctivitis cases were delivered by cesarean section. 47% had a history of maternal premature rupture of membrane (PROM) and 11% genitourinary infection. 65% were preterm. 61% had low birth weight and 32% an APGAR score below 7 at birth. Also 22% had septicemia. The most common organism causing ophthalmia was S. aureus (31%). Other pathogens consisted of E. coli (23%), S. epidermidis (22%), Klebsiella (10%), N. gonorrheae (3%), C. trachomatis (2%), and Pseudomonas aeruginosa (2%). In neonates with septicemia, the most common cause of conjunctivitis was E. coli (38%). Neonates with E. coli conjunctivitis had significantly (p<0.05) higher rate of history of maternal genitourinary infection and higher rate of septicemia compared to non-E. coli cases.
Conclusion: Data such as birth weight, APGAR score, presence of septicemia, maternal genitourinary infections and PROM may play a role in developing neonatal conjunctivitis with different pathogens.