en donde se revisaron las historias clínicas de pacientes con diagnóstico de conjuntivitis neonatal con resultados de cultivos positivos de secreción conjuntival en un hospital de tercer nivel en la ciudad de Medellín. Se estudiaron variables sociodemográficas de la madre y el neonato, factores de riesgo asociados, resultados de los aislamientos microbiológicos, terapia antibiótica tópica y sistémica y sensibilidad antibiótica. resultados: Se identificaron un total de 69 neonatos, 65.22% de sexo masculino, con una edad media de 15.7 ± 8.3 días. Los principales agentes etiológicos encontrados fueron Staphylococcus epidermidis (20 pacientes, 28.9%), Staphylococcus aureus (12 pacientes, 17.3%) y Haemophilus influenzae (9 pacientes, 13.0%). Con las pruebas realizadas no se obtuvo crecimiento para Neisseria gonorrhoeae, ni hubo resultado positivo para Chlamydia trachomatis. Los factores de riesgo maternos periparto encontrados con mayor frecuencia fueron: la ruptura prematura de membranas ovulares (n = 16, 21.33%), infección del tracto urinario (n = 7, 10.1%), síndrome de parto pretérmino (n = 6, 8.00%) y vulvovaginosis (n = 5, 7.25%). Para la familia de Staphylococcus se encontró resistencia a la oxacilina del 26% (n = 18) y del 15% (n = 11) a las tetraciclinas. conclusión: El perfil epidemiológico de la conjuntivitis neonatal ha cambiado en la última década. Actualmente la causa más frecuente son agentes no gonocócicos. Se encontró un importante número de pacientes con Staphylococcus aureus meticilinorresistente.
We reviewed the medical records of patients diagnosed with neonatal bacterial conjunctivitis with positive cultures of conjunctival secretion. Sociodemographic variables of the mother and the neonate, associated risk factors, results of the microbiological isolations, topical and systemic antibiotic therapy and antibiotic sensitivity were recorded. Results: A total of 69 newborns were identified, 65.22% were male, the average age was 15.7 ± 8.3 days. Major etiological agents identified were Staphylococcus epidermidis (n = 20, 28.9%), Staphylococcus aureus (n = 12, 17.3%) and Haemophilus influenzae (9 patients, 13.0%). There were no positive isolates for Chlamydia trachomatis or Neisseria gonorrhoeae. The most common maternal peripartum risk factors were premature rupture of the ovular membranes (n = 16, 21.33%), urinary tract infection (7 cases, 10.1%), preterm birth syndrome (n = 6, 8.00%) and bacterial vaginosis (5 cases, 7.25%). Resistance to oxacillin 26% (n = 18) and tetracyclines 15% (n = 11) was observed in patients with Staphylococcus infection. Conclusion: Over the years, the epidemiology of neonatal conjunctivitis has changed. Nowadays, gonococcal pathogens are not the most common cause of neonatal conjunctivitis. A significant number of patients with methicillin-resistant S. aureus were observed.
Conclusión: La realización de pruebas clínicas, laboratorio y cuestionarios de síntomas, permiten realizar el diagnóstico integral de la enfermedad ojo seco según las recomendaciones del DEWS II, apoyando la clasificación del mismo, reconocimiento de factores de riesgo y planteamiento de posibles etiologías que ayudan en el tratamiento.
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