Prevalence, Etiological Agents, and Management of Ophthalmia Neonatorum from January 2020- December 2021 at Georgetown Public Hospital Corporation
Introduction
Introduction: Before April 2021, there was a vast increase in ON cases at GPHC. AQuality Improvement project was initiated by introducing routine eye careprophylaxis. On initiation, the baseline incidence was 2.3% comparedwith 0.6% of the total live births on completion, which showed asignificant decline. This has caused the researcher to investigate the trueprevalence, common organisms involved, and management and to assessthe need for a standardized management protocol.
Objectives
Objective: To evaluate the prevalence of Ophthalmia neonatorum between January2020 – December 2021 in NICU, SDU, and Postnatal wards. To identifythe most common etiologic agents involved and to assess the need for astandardized management protocol.
Method
Methodology: A retrospective, descriptive cross-sectional study usinganalysis of relevant charts of neonates from NICU, SDU, and PostnatalWard.
Results
Results: There was a significant increase in the prevalence of ON from 2020 to2021, which was 3.33% and 3.86%, respectively, with a p-value of 0.03.Coagulase Negative Staph (CNS) represented the most common cause ofON, with 32.9% in 2020 compared to 20.5% in 2021. Negative culturesaccounted for 19.5% – 24.5% during the study period. Staph aureusaccounted for 15.8% in 2020 compared with 8% in 2021. Pseudomonassp. and Klebsiella accounted for 7.9% and 6.7% in 2020, compared with15.4% and 10.8% in 2021. The most common presenting symptom wasyellow eye secretions (90% of all cases), and most patients presented withsymptoms within the first seven days of life. Gentamicin andCiprofloxacin showed sensitivity to most organisms, with resistant strainssensitive to Clindamycin.
Conclusion
Conclusion: There was a significant increase in the prevalence of ON in 2021 ascompared to 2020 despite the majority of patients who developed ONreceived Tetracycline prophylaxis. The majority of patients grew Coagulasenegative staph in their eye swabs. Negative cultures accounted for asignificant percentage despite the presence of conjunctivitis.
Recommendations
Recommendations: Coagulase-negative staph (CNS) sensitivity and resistance profiles shouldbe routinely done on all neonatal eye swab cultures. The current Eye Care Protocol should be revised to replace Tetracyclinewith Gentamicin or Ciprofloxacin eye drops as the prophylactic agent.Clindamycin eye drops should be considered for Staph aureus species,including MRSA.