Severe ophthalmia neonatorum in Southwest China: a 5-year review of demographics, microbiological results, and risk factors

Purpose To evaluate the microbiological characteristics and risk factors of severe ophthalmia neonatorum (ON) in Southwest China. Methods In this retrospective review, data on demography, microbiological results, and risk factors were analyzed. Data were obtained from medical records of patients with severe ON treated at Children’s Hospital of Chongqing Medical University from January 2015 to December 2019. To understand the risk factors for severe ON, maternal and neonatal factors were compared between the severe and non-severe ON groups. Results A total of 1397 neonates with ON were included, of whom 12% ( n = 172) had severe ON, and 88% ( n = 1225) had non-severe ON. Microbial detection and drug susceptibility tests were performed on 169 patients with severe ON. Culture results were positive for 76 patients, with gram-positive bacteria in 71.1% ( n = 54), gram-negative bacteria in 25.0% ( n = 19), and multiple microorganisms in 3.9% ( n = 3) neonates. The most commonly detected organisms were Staphylococcus aureus (29%) and Staph. epidermis (27%), followed by Escherichia coli (8%). Neisseria gonorrhea (8%), Moraxella catarrhal (5%), Streptococcus pneumoniae (4%), Haemophilus influenza (4%), and Chlamydia trachomatis (1%). The main risk factors for severe ON were obstruction of the nasolacrimal duct (χ 2 = 10.794, P = 0.001), meconium aspiration syndrome (χ 2 = 6.252, P = 0.012), and cesarian section (χ 2 = 5.118, P = 0.024). Neonatal ocular prophylaxis was a protective factor for severe conjunctivitis (χ 2 = 6.905, P = 0.009). Conclusions Staphylococcus is the most common pathogen of severe ON. Nasolacrimal duct obstruction (NLDO) is a risk factor for ON.