Conjunctivitis is inflammation of conjunctiva of the eye, which is the membrane covering the white region of the eye. Neonatal Conjunctivitis can be a severe disorder that occurs shortly after delivery in newborns (within a period of 30 days).
What are the other Names for this Condition? (Also known as/Synonyms)
- Neonatal Conjunctivitis – due to Non-Sexually Transmitted Bacteria
- Neonatal Conjunctivitis, NOS
- Ophthalmia Neonatorum, NOS
What is Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis? (Definition/Background Information)
- Conjunctivitis is inflammation of conjunctiva of the eye, which is the membrane covering the white region of the eye
- In this condition the white part of the eye turns red or pink, and hence it is known as Pink Eye. The infection may affect either one, or both the eyes, and is accompanied by inflammation, irritation, with watery discharge from the eyes. Under normal circumstances, Conjunctivitis does not affect vision
- Neonatal Conjunctivitis can be a severe disorder that occurs shortly after delivery in newborns (within a period of 30 days). It may be caused due to bacterial, viral microorganisms, or even on exposure to certain chemical substances (which is quite infrequent)
- Some forms of Neonatal Conjunctivitis are commonly caused by certain bacteria, such as staphylococcus aureus, streptococcus pneumoniae, and hemophilus influenzae. These may be collectively referred to as Neonatal Conjunctivitis – due to Non-Sexually Transmitted Bacteria
- The symptoms clear spontaneously within a few weeks, in most of such cases. However, antimicrobial treatment and supportive care speeds up the healing process
Note: Severe forms of Neonatal Conjunctivitis caused by the bacteria neisseria or chlamydia, and by the virus herpes simplex, are not discussed here.
Who gets Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis? (Age and Sex Distribution)
- Newborn babies, during the course of delivery
- Both male and female genders are equally affected
What are the Risk Factors for Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis? (Predisposing Factors)
The risk factors for Neonatal Conjunctivitis – Non-Sexually Transmitted Bacteria, include:
- Exposure to bacteria at the time of delivery, which are present in the infected mother’s vagina or genital tract. The newborns are at risk during the time of their birth and may acquire the infection from their mother
- Neglecting to administer anti-microbial eye drops (or use of improper, inadequate eye drops by the healthcare provider), in the period immediately following birth of the child
- Premature delivery (preterm)
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis? (Etiology)
- Neonatal Conjunctivitis is caused by a variety of bacteria and some of these commonly include: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus viridans, and Hemophilus influenzae
- Other bacteria that cause the condition, rather infrequently are: Enterobacter, Escherichia coli, Klebsiella pneumoniae, Proteus, Serratia marcescens
- Most of these bacteria reside in the female genital tract, apart from other regions. As the infant passes through the cervix during delivery, transmission of the pathogen occurs. These bacteria account for around 15% of all Neonatal Conjunctivitis cases
What are the Signs and Symptoms of Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis?
Common signs and symptoms of Neonatal Conjunctivitis (due to non-sexually transmitted bacteria) are:
- Tenderness, inflammation, and redness of the eye(s); this may begin in one eye and slowly progress to the other
- Discharge of pus-like fluid from the eyes with formation of crusts
- The onset of symptoms for bacteria-caused Neonatal Conjunctivitis may take place anywhere within 4 days to 2 weeks
How is Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis Diagnosed?
Neonatal Conjunctivitis – Non-Sexually Transmitted Bacteria is diagnosed using the following tools:
- The ophthalmologist or physician performs an eye examination, evaluates the child’s and mother’s medical history, and the time period for onset of symptoms in the newborn child is noted (this factor could often be conclusive)
- Slit lamp exam (if necessary), for a detailed study of the eye
- Examination of conjunctival scrapings, to isolate the kind of bacteria causing the infection
- Differential diagnosis of other types of Conjunctivitis should be considered, in order to eliminate other eye conditions
- Low birth weight and a preterm delivery, accompanied by signs of Conjunctivitis, may indicate infection by certain specific bacteria types
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis?
Complications may arise if the cornea is involved, or if there is a late recognition of the condition, leading to a delayed treatment. Nevertheless, most cases of Neonatal Conjunctivitis – Non-Sexually Transmitted Bacteria, are usually self-limiting and not serious. The complications may include:
- Corneal ulcer, scar
- Permanent eye damage, loss of vision in newborns (this is extremely rare)
- Higher risk for other complications like central nervous system problems, pneumonia, septicemia
- Chronic recurrence of the condition
How is Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis Treated?
Early diagnosis and speedy treatment is important to prevent permanent complications from bacteria-associated Neonatal Conjunctivitis. The underlying health disorders (if any) also require treatment. Some management measures include:
- Conjunctivitis in Newborn from most bacterial types resolves spontaneously within a few weeks. It also responds well to supportive treatment with antimicrobial agents. The exception to this is Neonatal Conjunctivitis, which is caused by chlamydia & neisseria bacteria
- Use of lubricating eye drops may soothe the eyes, and helps remove crust formation
- The eyes may be cleaned regularly with saline solution to remove mucus formation
- Application of warm compress can help reduce discomfort
- Regular application of topical antibiotic ointments such as erythromycin or tetracycline
- Follow-up care is regularly required; more so if the condition aggravates
How can Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis be Prevented?
- To avoid Neonatal Conjunctivitis caused by bacterial microorganisms, a newborn child should be treated with erythromycin antibiotic eye ointment, shortly after birth
- The condition is highly infectious, if caused by bacteria or a virus. Hence, adequate precaution must be observed by the healthcare providers to prevent it from spreading
- Control spread of the condition by washing hands regularly, maintaining hygiene and cleanliness. This instruction is mainly directed towards the medical staff and mother of the child
What is the Prognosis of Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis? (Outcomes/Resolutions)
- Most cases of Neonatal Conjunctivitis (due to non-sexually transmitted bacteria) are self-limiting and have an excellent outcome, when treated promptly and early with topical antibiotics/antibacterial applications, and on providing suitable supportive management
- An exception to this is Conjunctivitis in newborn, caused by the bacteria pseudomonas. Late recognition of the condition and/or a delay in treatment, could lead to inflamed intraocular cavities (endophthalmitis), and result in fatal consequences
- Bacterial Conjunctivitis (caused by the bacterium staphylococcus) is a chronic infection and can recur periodically, if conditions are conducive for its recurrence
Additional and Relevant Useful Information for Neonatal Non-Sexually Transmitted Bacteria Conjunctivitis:
- Neonatal Conjunctivitis caused by neisseria gonorrhoeae is termed as Gonococcal Conjunctivitis
- Neonatal Conjunctivitis caused by chlamydia trachomatis is termed as Inclusion (Chlamydial) Conjunctivitis
- Neonatal Conjunctivitis caused by herpes simplex virus is termed as Neonatal Keratoconjunctivitis
What are some Useful Resources for Additional Information?
References and Information Sources used for the Article:
http://kidshealth.org/kid/ill_injure/sick/conjunctivitis.html (accessed on 02/23/13)
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002005/ (accessed on 02/23/13)
http://www.mayoclinic.com/health/pink-eye/DS00258/DSECTION=causes (accessed on 02/23/13)
http://www.cdc.gov/conjunctivitis/newborns.html (accessed on 02/23/13)
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002573/ (accessed on 02/23/13)
Helpful Peer-Reviewed Medical Articles:
Sandström, K. I., Bell, T. A., Chandler, J. W., Kuo, C. C., Wang, S. P., Grayston, J. T., ... & Holmes, K. K. (1984). Microbial causes of neonatal conjunctivitis. The Journal of pediatrics, 105(5), 706-711.
Rours, I. G., Hammerschlag, M. R., Ott, A., De Faber, T. J., Verbrugh, H. A., de Groot, R., & Verkooyen, R. P. (2008). Chlamydia trachomatis as a cause of neonatal conjunctivitis in Dutch infants. Pediatrics, 121(2), e321-e326.
Rees, E. L. I. S. A. B. E. T. H., Tait, I. A., Hobson, D., Byng, R. E., & Johnson, F. W. (1977). Neonatal conjunctivitis caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Sexually Transmitted Infections, 53(3), 173-179.
Hammerschlag, M. P. (1993). Neonatal conjunctivitis. Pediatric annals, 22(6), 346-351.
Rapoza, P. A., Quinn, T. C., Kiessling, L. A., & Taylor, H. R. (1986). Epidemiology of neonatal conjunctivitis. Ophthalmology, 93(4), 456-461.
Fransen, L., Van den Berghe, P., Mertens, A., Van Brussel, K., Clara, R., & Piot, P. (1987). Incidence and bacterial aetiology of neonatal conjunctivitis. European journal of pediatrics, 146(2), 152-155.
Bernstein, G. A., Davis, J. P., & Katcher, M. L. (1982). Prophylaxis of neonatal conjunctivitis: an analytic review. Clinical pediatrics, 21(9), 545-550.
Sandström, I. (1987). Treatment of neonatal conjunctivitis. Archives of Ophthalmology, 105(7), 925-928.
Pandey, K. K., Bhat, B. V., Kanungo, R., Srinivasan, S., & Rao, R. S. (1990). Clinico-bacteriological study of neonatal conjunctivitis. The Indian Journal of Pediatrics, 57(4), 527-531.
Verma, M., Chhatwal, J., & Varughese, P. V. (1994). Neonatal conjunctivitis: a profile. Indian pediatrics, 31(11), 1357-1361.