Yescas-Buendía G, Udaeta-Mora E, Arredondo-García J L, Guerra F, Chávez-González C, Joachim-Roy H
División de Pediatría, Hospital de Gineco-Obstetricia #4, Instituto Mexicano del Seguro Social, D.F.
Bol Med Hosp Infant Mex. 1993 Aug;50(8):570-6.
32 newborns with neonatal Chlamydia trachomatis conjunctivitis were reported. Diagnosis was carried out through immunofluorescent monoclonal antibody of conjunctiva scraping staining; 37 conjunctiva samples were taken from same number of newborn patients not responds to topical antibiotic treatment. The sample came out from two different third level institutions with maternal facilities and attending more than five thousand deliveries per year each one of them. Were studied incidence and clinical picture from neonatal C. trachomatis conjunctivitis. Positive immunofluorescent and conjunctive culture of secretion to C. trachomatis in the sample were 86 per cent (32 out of 37). 19 of the newborns acquired Staphylococcus associated to C. trachomatis (59%): nine with S. aureus in six Staphylococcus negative coagulase was isolated and four with the latest two. Out of 32 patients who demonstrated positive cultures to C. trachomatis (86%), 22(69%) were males and ten (31%) were females. Significant proportion of newborns were identified as small for gestational age. 18 of them were born by natural way and 14 by cesarean section. In 16/32 (50%) had interstitial pneumonia by Chlamydia. The main clinical findings were stated as: conjunctiva exudate in different stages including purulent secretion and oedema or inflammation of the ophthalmic conjunctiva. Those newborns where topical therapy did not irradiate the organism and demonstrated clinical picture persistence or relapse and diagnosis of C. trachomatis infection, systemic treatment with erythromycin and topic tetracycline were installed, disappearing all symptoms. Maternal history related to neonatal disease were mainly: endocervical infection, miscarriages and or preterm delivery.
报告了32例新生儿沙眼衣原体结膜炎。通过结膜刮片免疫荧光单克隆抗体染色进行诊断;从相同数量的对局部抗生素治疗无反应的新生儿患者中采集了37份结膜样本。样本来自两个不同的三级医疗机构,每个机构都有产科设施,每年接生超过5000例。研究了新生儿沙眼衣原体结膜炎的发病率和临床表现。样本中沙眼衣原体免疫荧光阳性和分泌物结膜培养阳性率为86%(37例中的32例)。19例新生儿感染了与沙眼衣原体相关的葡萄球菌(59%):9例感染金黄色葡萄球菌,6例凝固酶阴性葡萄球菌中分离出2例,4例感染后两种。在32例沙眼衣原体培养阳性的患者中(86%),22例(69%)为男性,10例(31%)为女性。相当比例的新生儿被确定为小于胎龄儿。其中18例为自然分娩,14例为剖宫产。16/32(50%)的新生儿患有衣原体间质性肺炎。主要临床表现为:不同阶段的结膜渗出物,包括脓性分泌物以及睑结膜水肿或炎症。对于那些局部治疗未能清除病原体、临床表现持续或复发且诊断为沙眼衣原体感染的新生儿,采用红霉素全身治疗和四环素局部治疗,所有症状均消失。与新生儿疾病相关的母亲病史主要有:宫颈感染、流产和/或早产。