Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
Int J STD AIDS. 2023 Oct;34(12):860-868. doi: 10.1177/09564624231173028. Epub 2023 Jun 20.
We describe 12 cases of chlamydial ophthalmia neonatorum and the current scientific evidence on its prevention and treatment. The data presented were obtained from the "Maduo" study, a prospective observational study of the relationship between curable sexually transmitted infections and adverse neonatal outcomes at four antenatal clinics in Gaborone, Botswana.
Infants of mothers with perinatal chlamydia infection were evaluated for chlamydial ophthalmia neonatorum based on clinical presentation of conjunctivitis or positive test via GeneXpert CT/NG assay. Data on 29 infants born to mothers with postnatal infection were analysed.
12 infants were diagnosed with chlamydial ophthalmia neonatorum. Eight of those cases were confirmed with the GeneXpert CT/NG assay while four were identified as probable cases based on clinical history and presentation. Overall, nine infants presented with signs of conjunctivitis, while three who had a positive diagnostic test result had asymptomatic infection. All but one infant had received ocular 1% tetracycline prophylaxis at birth, and four infants had signs suggestive of chlamydial pneumonia at presentation. Two out of five symptomatic cases whose mothers reported completion of their treatment course with erythromycin had lingering symptoms.
Our findings affirm that the current prophylaxis and treatment modalities for chlamydial ophthalmia neonatorum are inadequate. To the extent feasible in low- and middle-income countries, we recommend implementation of routine screening and treatment in pregnant women.
我们描述了 12 例衣原体性新生儿眼炎病例，并介绍了目前关于其预防和治疗的科学证据。本文的数据来源于“玛多”研究，这是一项在博茨瓦纳哈博罗内的 4 家产前诊所进行的、针对可治愈性性传播感染与不良新生儿结局之间关系的前瞻性观察性研究。
根据结膜炎的临床表现或 GeneXpert CT/NG 检测呈阳性，对患有围产期衣原体感染的母亲所生的婴儿进行衣原体性新生儿眼炎评估。对 29 例产后感染的婴儿进行数据分析。
诊断出 12 例婴儿患有衣原体性新生儿眼炎。其中 8 例经 GeneXpert CT/NG 检测确诊，4 例根据临床病史和表现被确定为疑似病例。总的来说，9 例婴儿出现结膜炎症状，而 3 例经诊断检测呈阳性的婴儿为无症状感染。除 1 例婴儿外，所有婴儿均在出生时接受了 1%四环素眼部预防治疗，4 例婴儿在就诊时出现疑似衣原体肺炎的症状。在 5 例有症状的婴儿中，有 2 例其母亲报告完成了红霉素治疗疗程，但仍有遗留症状。
我们的研究结果证实，目前针对衣原体性新生儿眼炎的预防和治疗方案并不完善。在中低收入国家，我们建议尽可能对孕妇进行常规筛查和治疗。
