Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.
Acta Paediatr. 2018 May;107(5):774-779. doi: 10.1111/apa.14227. Epub 2018 Feb 6.
Our aim was to study prospectively the aetiology of neonatal conjunctivitis in a population-based setting.
Altogether 173 neonates with clinical conjunctivitis aged on average 20 (SD 10) days were recruited from child welfare clinics in Oulu, Finland, in 2010-2015. Conjunctival specimens were collected from 167 neonates for multiplex polymerase chain reaction to detect 16 respiratory viruses, from 163 for polymerase chain reaction to detect Chlamydia trachomatis and Neisseria gonorrhoeae and from 160 for bacterial culture studies. The cases were followed up until the age of 18 months.
Viral conjunctivitis was diagnosed in 8/167 (4.8%; 95% CI 2.1-9.2%), chlamydial or gonococcal conjunctivitis in 0/163 cases (0%; 95% CI 0-2.2%) and other bacterial conjunctivitis in 58/160 (36%; 95% CI 29-44%). Rhinovirus was found at the ocular site in 4/167 (2.4%) neonates, adenovirus in 3/167 (1.8%) and bocavirus in 1/167 (0.6%). The most commonly isolated bacteria included Staphylococcus aureus (16%), Moraxella catarrhalis (9.4%) and Streptococcus pneumoniae (3.1%). None of these pathogens was associated with the 4/173 (2.3%) cases later operated on for persistent nasolacrimal duct obstruction.
Chlamydia trachomatis was a rare pathogen in neonatal conjunctivitis in a population-based setting, but respiratory viruses were detected more frequently than indicated earlier.
本研究旨在以人群为基础，前瞻性地研究新生儿结膜炎的病因。
2010 年至 2015 年，我们在芬兰奥卢的儿童福利诊所共招募了 173 名平均年龄为 20（SD 10）天的患有临床结膜炎的新生儿。从 167 名新生儿中采集了结膜标本，用于多重聚合酶链反应检测 16 种呼吸道病毒，从 163 名新生儿中采集了聚合酶链反应检测沙眼衣原体和淋病奈瑟菌，从 160 名新生儿中采集了细菌培养研究。对这些病例进行了随访，直至 18 个月大。
在 167 例中，诊断为病毒性结膜炎 8 例（4.8%；95%CI 2.1-9.2%），在 163 例中，诊断为沙眼衣原体或淋病奈瑟菌结膜炎 0 例（0%；95%CI 0-2.2%），在 160 例中，诊断为其他细菌性结膜炎 58 例（36%；95%CI 29-44%）。在 167 例新生儿中，在眼部发现鼻病毒 4 例（2.4%），腺病毒 3 例（1.8%），博卡病毒 1 例（0.6%）。最常分离到的细菌包括金黄色葡萄球菌（16%）、卡他莫拉菌（9.4%）和肺炎链球菌（3.1%）。在这些病原体中，没有一种与 173 例中的 4 例（2.3%）后来因持续鼻泪管阻塞而手术的病例有关。
在人群中，沙眼衣原体是新生儿结膜炎的罕见病原体，但呼吸道病毒的检出率高于以前的报道。
