Resistance pattern of bacterial agents causing ophtalmia neonatorum

One of the most common infections in neonatal period is ophthalmia neo-natorum. In this study، the bacterial agents، drug resistance and susceptibility of bacteri-al agents were studied.

In this study a total of 72 newborns with ophthalmia neonatorum admitted in Bahrami Hospital in Tehran during the years 2008-2011 were continuously enrolled in a case series، descriptive study. Demographic data، including age، sex، cause of admis-sion and culture of discharge from the eyes and its antibiogram، as well as experimental treatments and treatment outcomes were collected.

Forty four infants (61. 1%) were males and 28 (38. 9%) were females and the mean age on admission was 11. 6±7. 7 days. In 51 patients (70. 8%) the onset of ophthal-mia neonatorum was prior to admission. More than 56% of cases with ophthalmia neonatorum were associated with sepsis. On the other hand، positive blood culture was detected in 15. 3% of cases. Among 72 neonates with ophthalmia neonatorum، 26 (36. 1%) had a positive culture of the eye discharge. The most common causes of bacterial agents were Staphylococcus aureus (46. 1%) (12 of 26 cases). Other causes included streptococcus species (23%)، Pseudomonas (15. 3%)، E-coli (11. 5%) and Haemophilus influenza (3. 8%). The most frequent causes of drug resistance were Ampicillin، Penici-llin، Cefixime، and Ceftazidime (100% resistance). The most sensiti-ve antibiotics were vancomycin and imipenem (100% sensitivity). Based on the conventional treatment، clinical response to local gentamicin was approximately 60%. Sulfacetamide was associated with no clinical response in 40% of cases.

The antibiogram and clinical response to empiric treatment showed that resistance to ampicillin and some third generation of cephalosporine was 100%. Aminoglycosides’ sensitivity was more than 50% locally and systemically. Our recommendation is performing eye discharge culture before antibiotic treatment. More studies with numerous cases should be done for better definition of bacterial resistance.