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Gonococcal infection in the newborn

Author
Michael E Speer, MD
Section Editors
Leonard E Weisman, MD
Sheldon L Kaplan, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Perinatal acquisition of sexually transmitted diseases (STDs) can have serious consequences for the newborn [1]. Ophthalmia neonatorum (newborn conjunctivitis) was caused principally by Neisseria gonorrhoeae at one time in the United States and was the most common cause of blindness. Although this newborn infection has decreased in frequency throughout the world, the consequences of untreated disease remain grave. Gonococcal infection in the newborn is reviewed here. Neonatal infection with other sexually transmitted organisms is discussed separately. (See "Chlamydia trachomatis infections in the newborn" and "Congenital syphilis: Evaluation, management, and prevention" and "Hepatitis viruses and the newborn: Clinical manifestations and treatment" and "Diagnostic testing for HIV infection in infants and children younger than 18 months".)

EPIDEMIOLOGY

Gonococcal infections in pregnant women are estimated at less than 1 percent in developed countries and between 3 and 15 percent in developing regions; >50 percent of the infections in the latter countries are caused by penicillinase-producing strains (PPNG) [2]. Perinatal transmission is estimated to occur in 30 to 40 percent of cases. Coinfection with Chlamydia trachomatis is frequent and HIV transmission is heightened in the presence of gonorrhea [3-5]. (See "Epidemiology of Chlamydia trachomatis infections" and "Treatment of uncomplicated gonococcal infections", section on 'HIV counseling and testing'.)

In one series of neonatal gonococcal infections in Florida from 1984 through 1989, 68 cases were documented; 81 percent of these were gonococcal ophthalmia neonatorum [6]. A number of studies of the causes of ophthalmia neonatorum from different parts of the world have shown a decreasing frequency of N. gonorrhoeae as the etiology of the infection, as illustrated by the following:

A study of 332 infants with conjunctivitis from Argentina established a pathogen in 50 percent of cases [7]. Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus were the most common organisms. No cases of gonococcal ophthalmia neonatorum were identified, and C. trachomatis accounted for 8 percent of infections.

N. gonorrhoeae and C. trachomatis were responsible for <5 percent of cases of ophthalmia neonatorum in a series of 81 infants with this infection in United Arab Emirates; S. aureus was the most common pathogen [8].

                   

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Literature review current through: Nov 2016. | This topic last updated: Thu Jun 18 00:00:00 GMT+00:00 2015.
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