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Normal ocular flora in newborns delivered in two hospital centers in Argentina and Paraguay

  • Clinical Investigation
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Abstract

Purpose

To determine the spectrum of normal conjunctival flora in newborns in two hospital centers in North Argentina and Paraguay.

Methods

In this prospective observational study, conjunctival specimens were obtained from the right eyes of newborns prior to the application of any topical medications. Culture samples were also obtained from the cervicovaginal secretions of the infants’ mothers. All samples were directly inoculated into culture media and all growth were identified and quantified.

Results

Among the 190 newborns studied, 126 were delivered vaginally and 64 via caesarean section (C-section). A total of 180 different bacterial strains were acquired from the vaginally delivered infants and 77 from the C-section group (P=0.078, Student’s t-test). Conjunctival cultures obtained within one hour of birth showed that 85 out of 101 samples (84%) from both the vaginal and C-section group had positive cultures, compared to 84 out of 89 samples (94%) obtained more than 1 h after birth (P<0.001). Among the vaginally delivered newborns, the most common bacteria isolated were coagulase-negative Staphylococcus (in 69 samples, 38%), Propionibacterium spp (36, 20%) and Corynebacterium spp (29, 16%). In the CES, the most common isolates were coagulase-negative Staphylococcus (39, 51%), Propionibacterium spp (22, 29%) and Staphylococcus aureus (6, 8%). There was a significantly higher proportion of gram-positive rods (P=0.017) isolated from infants delivered vaginally (16%) than from those delivered by C-section (5%). No Neisseria gonorrhoeae were isolated in conjunctival samples. Among the 130 organisms isolated from cervicovaginal secretions in 81 out of 189 mothers, the most common organisms were Lactobacillus spp. (47%), Corynebacterium spp (21%), Gardnerella vaginalis (15%), and Candida spp (14%). No Neisseria gonorrhoeae or Chlamydia trachomatis were found in cervicovaginal samples.

Conclusion

The most common conjunctival bacteria in newborns delivered by either vaginal birth or C-section were coagulase-negative Staphylococcus. The proportion of positive conjunctival cultures was higher for infants delivered vaginally than for C-section delivery.

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References

  1. Assadian O, Assadian A, Aspock C, Hahn D, Koller W (2002) Prophylaxis of ophthalmia neonatorum—a nationwide survey of the current practice in Austria. Wien Klin Wochenschr 114:194–199

    PubMed  CAS  Google Scholar 

  2. Armstrong RA (2000) The microbiology of the eye. Ophthalmic Physiol Opt 20:429–441

    Article  PubMed  CAS  Google Scholar 

  3. Bredow C, Mino De Kaspar H, Klauss V (1999) Chlamydia trachomatis bei Augeninfektionen in Paraguay. Department of Ophthalmology, University of Munich, Munich (Doctoral Thesis)

    Google Scholar 

  4. Bredow C, Mino De Kaspar H, Moralez M, Klauss V (1997) Clamydia trachomatis bei Augeninfektionen in Paraguay. Ophthalmologe 132(Suppl):94

    Google Scholar 

  5. Brook I, Barrett CT, Brinkman CR 3rd, Martin WJ, Finegold SM (1979) Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva: a prospective study. Pediatrics 63:451–455

    PubMed  CAS  Google Scholar 

  6. Caldwell HD, Wood H, Crane D, Bailey R, Jones RB, Mabey D, Maclean I, Mohammed Z, Peeling R, Roshick C, Schachter J, Solomon AW, Stamm WE, Suchland RJ, Taylor L, West SK, Quinn TC, Belland RJ, McClarty G (2003) Polymorphisms in Chlamydia trachomatis tryptophan synthase genes differentiate between genital and ocular isolates. J Clin Invest 111:1757–1769

    Article  PubMed  CAS  Google Scholar 

  7. Di Bartolomeo S, Mirta DH, Janer M, Rodriguez Fermepin MR, Sauka D, Magarinos F, de Torres RA (2001) Incidence of Chlamydia trachomatis and other potential pathogens in neonatal conjunctivitis. Int J Infect Dis 5:139–143

    Article  PubMed  Google Scholar 

  8. Di Bartolomeo S, Rodriguez Fermepin M, Sauka DH, Alberto de Torres R (2002) Prevalence of associated microorganisms in genital discharge, Argentina. Rev Saúde Pública 36:545–552

    Article  PubMed  Google Scholar 

  9. Foster A, Klauss V (1995) Ophthalmia neonatorum in developing countries. N Engl J Med 332:600–601

    Article  PubMed  CAS  Google Scholar 

  10. Isenberg SJ, Apt L, Yoshimori R, McCarty JW, Alvarez SR (1988) Source of the conjunctival bacterial flora at birth and implications for ophthalmia neonatorum prophylaxis. Am J Ophthalmol 106:458–462

    PubMed  CAS  Google Scholar 

  11. Isenberg SJ, Apt L, Yoshimori R, Leake RD, Rich R (1994) Povidone–iodine for ophthalmia neonatorum prophylaxis. Am J Ophthalmol 118:701–706

    PubMed  CAS  Google Scholar 

  12. Isenberg SJ, Apt L, Valenton M, Del Signore M, Cubillan L, Labrador MA, Chan P, Berman NG (2002) A controlled trial of povidone–iodine to treat infectious conjunctivitis in children. Am J Ophthalmol 134:681–688

    Article  PubMed  CAS  Google Scholar 

  13. Laga M, Plummer FA, Nzanze H, Namaara W, Brunham RC, Ndinya-Achola JO, Maitha G, Ronald AR, D’Costa LJ, Bhullar VB (1986) Epidemiology of ophthalmia neonatorum in Kenya. Lancet 2:1145–1149

    Article  PubMed  CAS  Google Scholar 

  14. Laga M, Plummer FA, Piot P, Datta P, Namaara W, Ndinya-Achola JO, Nzanze H, Maitha G, Ronald AR, Pamba HO (1988) Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum. A comparison of silver nitrate and tetracycline. N Engl J Med 318:653–657

    Article  PubMed  CAS  Google Scholar 

  15. Mino De Kaspar H, Hoepfner AS, Engelbert M, Thiel M, Ta CN, Mette M, Schulze-Schwering M, Grasbon T, Sesma-Vea B, Casas JM, Iturralde-Goni R, Klauss V, Kampik A (2001) Antibiotic resistance pattern and visual outcome in experimentally-induced Staphylococcus epidermidis endophthalmitis in a rabbit model. Ophthalmology 108:470–478

    Article  PubMed  CAS  Google Scholar 

  16. Perkins RE, Kundsin RB, Pratt MV, Abrahamsen I, Leibowitz HM (1975) Bacteriology of normal and infected conjunctiva. J Clin Microbiol 1:147–149

    PubMed  CAS  Google Scholar 

  17. Rapoza PA, Quinn TC, Kiessling LA, Taylor HR (1986) Epidemiology of neonatal conjunctivitis. Ophthalmology 93:456–461

    PubMed  CAS  Google Scholar 

  18. Reeder JC, Westwell AJ, Hutchinson DN (1985) Indifferent streptococci in normal and purulent eyes of neonates. J Clin Pathol 38:942–945

    Article  PubMed  CAS  Google Scholar 

  19. Rummelt V, Boltze HJ, Bialasiewicz AA, Naumann GO (1990) Bacterial pathogen and resistance spectrum of the non-irritated conjunctiva. 7,845 preoperative smears at the ophthalmologic clinic of the Erlangen University. Klin Monatsbl Augenheilkd 197:172–175

    PubMed  Google Scholar 

  20. Rummelt V, Boltze HJ, Bialasiewicz AA, Naumann GO (1992) Incidence of postoperative bacterial infections after planned intraocular interventions. Klin Monatsbl Augenheilkd 200:178–181

    Article  PubMed  CAS  Google Scholar 

  21. Schaller U, Mino de Kaspar H, Schriever S, Klauss V (1997) Ophthalmia neonatorum caused by Chlamydia trachomatis. Rapid diagnosis and therapy. Ophthalmologe 94:317–320

    Article  PubMed  CAS  Google Scholar 

  22. Simoes JA, Giraldo PC, Faundes A (1998) Prevalence of cervicovaginal infections during gestation and accuracy of clinical diagnosis. Infect Dis Obstet Gynecol 6:129–133

    Article  PubMed  CAS  Google Scholar 

  23. Singer TR, Isenberg SJ, Apt L (1988) Conjunctival anaerobic and aerobic bacterial flora in paediatric versus adult subjects. Br J Ophthalmol 72:448–451

    Article  PubMed  CAS  Google Scholar 

  24. Speaker MG, Milch FA, Shah MK, Eisner W, Kreiswirth BN (1991) Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology 98:639–649

    PubMed  CAS  Google Scholar 

  25. Thiel HJ, Schumacher U (1994) Normal flora of the human conjunctiva: examination of 135 persons of various ages. Klin Monatsbl Augenheilkd 205:348–357

    PubMed  CAS  Google Scholar 

  26. Tozzini RI, Ruiz AI, Molteni OA, Belmonte A, Nogueras MG, Ombrella A (1998) Investigación de la flora vaginal autóctona y de transmisión sexual en 100 mujeres sintomáticas y asintomáticas. Obstet Ginecol Lat-Am 56:185–188

    Google Scholar 

  27. Tramont EC (1990) General or non-specific host defense mechanisms. In: Mandell GL, Douglas JRG, Benett JE (eds) Principles and practice of infectious diseases. Churchill Livingstone, New York

    Google Scholar 

  28. Weiss A, Brinser JH, Nazar-Stewart V (1993) Acute conjunctivitis in childhood. J Pediatr 122:10–14

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank the Hannelore-Georg Zimmermann Foundation, Munich, Germany, and Ludwig-Maximilians University, Munich, Germany, for their generous support of this project. We also would like to thank the Foundation Banco de Ojos (Eye Bank) “Fernando Occa del Valle,” Asunción, Paraguay, for their great assistance.

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Authors and Affiliations

  1. Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany

    Marcus Eder, Michael Koss, Volker Klauß & Herminia Miño de Kaspar

  2. Department of Microbiology, Research Institute of Health Science, National University of Asunción, Asunción, Paraguay

    Norma Fariña, Rosa R. Sanabria & Margarita Samudio

  3. Department of Ophthalmology, School of Medicine, Stanford University, 300 Pasteur Drive, Room A-157, Stanford, CA, 94305-5308, USA

    Christopher N. Ta & Herminia Miño de Kaspar

  4. Medical Laboratory Díaz Gíll, Asunción, Paraguay

    Cristina Cuevas

  5. Department of Gynecology, Mother–Infant Hospital of the Red Cross, Asunción, Paraguay

    Andrés Gines

  6. Department of Gynecology, Hospital Cruz Felipe Arnedo, Clorinda-Formosa, Argentina

    Manuel Simancas

Authors
  1. Marcus Eder
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  2. Norma Fariña
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  3. Rosa R. Sanabria
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  4. Christopher N. Ta
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  5. Michael Koss
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  6. Margarita Samudio
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  7. Cristina Cuevas
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  9. Manuel Simancas
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  10. Volker Klauß
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  11. Herminia Miño de Kaspar
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Corresponding author

Correspondence to Herminia Miño de Kaspar.

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Eder, M., Fariña, N., Sanabria, R.R. et al. Normal ocular flora in newborns delivered in two hospital centers in Argentina and Paraguay. Graefe's Arch Clin Exp Ophthalmo 243, 1098–1107 (2005). https://doi.org/10.1007/s00417-004-1096-3

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  • DOI: https://doi.org/10.1007/s00417-004-1096-3

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