Chlamydia trachomatis as a Cause of Neonatal Conjunctivitis in Dutch Infants

Abstract

BACKGROUND. Chlamydia trachomatis is the most common sexually transmitted pathogen in adults, which at delivery may be transmitted from mother to child and cause conjunctivitis and pneumonia. In the Netherlands, prenatal chlamydial screening and treatment of pregnant women is not routine practice. The contribution of C trachomatis to neonatal ophthalmic disease has not been studied in the Netherlands and remains unclear.

Etiology of Acute Conjunctivitis Due to Coxsackievirus A24 Variant, Human Adenovirus, Herpes Simplex Virus, and Chlamydia in Beijing, China

“…Previous data have shown an increase in the annual incidence of adult inclusion (chlamydial) conjunctivitis. Moreover, chlamydia has become the most frequent identifiable cause of neonatal conjunctivitis in many countries and the incidence has continued to rise annually (17,18).…”

Chlamydia trachomatis Infections in Neonates

“…trachomatis has been regularly reported as a leading agent for neonatal conjunctivitis, or ophthtalmia neonatorum in several studies analysing bacterial etiology. There are some surveys which still support that prominent position by investigating certain populations (Rours et al, 2008;Salpietro et al, 1999;Schaller & Klauss 2001). It is an interesting fact that the pathogen itself was first isolated precisely from a neonatal conjunctivitis in 1959 (Jones et al, 1959).…”

“…Vertical transmission rates are relatively high as 50-75% of infants born vaginally acquire C. trachomatis directly from their infected mothers (Chen et al, 2007;Rours et al, 2008). One or more organs of neonates may be colonised, including the nasopharynx as the leading target site.…”

“…C. trachomatis alone was responsible in Norway for only 6%, while in India and in Kenya for 24% and 28,7% of all neonatal conjunctivitis respectively (Dannevig et al, 1992;Mohile et al, 2002;Nsanze et al, 1996;Schaller & Klauss, 2001). In the Netherlands chlamydial screening of pregnant women is not a routine practice, which may play a significant role in high rates of C. trachomatis detection, which was calculated over 60% of studied infants presenting conjunctivitis (Rours et al, 2008). In the 1980's the incidence of chlamydial ophthalmia neonatorum was found 3 -250 cases per 1,000 live births, which has radically declined to 0,65 per 1,000 live births in Europe during the last three decades.…”

“…Misdiagnosis or mistreatment with topical and/or inadequate medications will just facilitate the persistence of the disease. Due to the slowly progressive nature of the untreated condition, it can be only occasionally diagnosed in infants after two months of age (Mårdh, 2002;Rours et al, 2008).…”