Bacterial ophthalmia neonatorum in Muhimbili medical centre Dar es Salaam

Abstract

This is a study conducted on 125 women admitted in labour in the maternity wing of Muhimbi1i Medical Centre, and in the babies born of these mothers. The main objective was to find out the prevalence of intrapartum gonococcal cervical infection in the mothers and the aetiology of ophthalmia neonatorum in their babies. The results showed that the prevalence of maternal gonococcal infection and incidence of ophthalmia neonatorum in their new borns were very high. The prevalence of maternal gonococcal infection was 4%, whereas the incidence of ophthalmia neonatorum in the babies was 20%. sta~hylQcoccuS aureus was the commonest orgnism causing neonatal conjuctivitis, and was isolated in 14 out of 25 babies with ophthalmia (56%). Other bacteria isolated were stre~tQCOCCUS pneumoniae (1 case) and Staphylococcus albus (2 cases). Gonococcal conjuctivitis was not seen in the new borns. There were 8 babies (32%) with clinical conjuctivitis but with negative cultures. Organismal resistance to antibiotics was seen in isolates from mothers as well as in the newborns. Thus, of those mothers with gonococcal infection, the organisms were resitant to penicillin in 20% of the cases. Also, amongst babies with Staphylococcal conjuctivitis, the sensitivity testing showed that 94% were resistant to penicillin. The organisms were highly sensitive to erythromycin and chloramphenicol. All infected babies responded promptly to 0.5% chloramphenical eye drops. In conclusion, the incidence of ophthalmia neonatorum in Muhimbili Medical Centre is high and there is a need for an effective ocular prophylaxis regime in the neonates. From the results of culture and sesitivity tests done, either erythromycin eye drops or chloramphenicol eye drops are recommended for the treatment and prophylaxis of the neonates.

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