Título

NEONATAL CONJUNCTIVITIS AT A BRAZILIAN TERTIARY CENTER: THE CURRENT RELEVANCE OF CHLAMYDIA TRACHOMATIS

Objetivo

Neonatal conjunctivitis is defined as any conjunctivitis occurring in the first 30 days of life. Despite its low incidence, systemic or ocular complications may be severe. The purpose of this study was to determine the etiology of neonatal conjunctivitis at a tertiary referral center in São Paulo, Brazil.

Método

Conjunctival swabs were taken from all neonates with clinical signs of conjunctivitis referred to HC-FMUSP from 2017 to 2020. Neisseria gonorrhoeae was investigated through bacterioscopy with Gram staining, chocolate agar and Thayer-Martin agar cultures; Chlamydia trachomatis was assessed by polymerase chain reaction (PCR). Data regarding clinical features was collected. The recommended treatment was intramuscular ceftriaxone 50mg/kg in a single dose and azithromycin oral syrup 20mg/kg/day once daily for 3 days.

Resultado

A total of 64 neonates were admitted to the ophthalmology emergency center during the 3-year study period. The main epidemiological and clinical data are shown in Table 1. Chlamydial conjunctivitis was diagnosed in 41 out of 53 tested neonates (77.3%). Microbial growth was detected in 15 out of 59 neonates assessed (25.4%). The most isolated bacterium was Staphylococcus epidermidis (n=7, 31.8% of positives), followed by Staphylococcus aureus (n=4, 18.2% of positives) and coagulase-negative Staphylococcus (n=4, 18.2% of positives). There were no cases of gonococcal conjunctivitis.

Conclusão

Chlamydia trachomatis was the most common pathogen causing neonatal conjunctivitis and its prevalence was higher than reported in previous articles from other countries. Routine screening and treatment of pregnant woman must be recommended in Brazilian prenatal care to prevent these conditions.