Conjunctival colonization of infants hospitalized in a neonatal intensive care unit: a longitudinal analysis.
OBJECTIVE
To determine the frequency of conjunctival colonization, identify the colonizing flora, and correlate culture results with physical findings in infants in a NICU.


METHODS
Surveillance study.


METHODS
Level III NICU of a large university teaching hospital.


METHODS
All infants admitted for longer than 24 hours during a 26-week period.


METHODS
Weekly bacterial conjunctival cultures were performed for all infants. The conjunctival appearance at the time of culture was recorded. The frequency, identity, and correlation of culture results with physical findings were determined.


RESULTS
One thousand ninety-one cultures were performed for 319 infants: 133 (42%) had no positive cultures and 186 (58%) had at least one positive culture. Culture analysis revealed that 411 (38%) were positive and yielded 494 isolates comprising more than 18 bacterial species. Bacteria most commonly isolated included coagulase-negative Staphylococcus (CoNS) (75%), viridans group streptococci (8.7%), Staphylococcus aureus (3.8%), Enterococcus species (2.6%), and Serratia marcescens (2.4%). The frequency of non-CoNS isolates increased significantly during the first 6 weeks of patient hospital stay (6% [1 to 3 weeks] to 12% [4 to 6 weeks]; P = .01), with an increasing trend to 15 weeks (18%). Correlation of bacteriologic results with physical findings demonstrated that infants with non-CoNS isolates exhibited conjunctival edema, erythema, or exudates more frequently than did infants with CoNS alone (30% vs 13%; P = .0001).


CONCLUSIONS
Conjunctival colonization was common among infants in a NICU. Prolonged hospitalization predisposes to colonization with potentially pathogenic organisms. Physical findings were more likely in patients with non-CoNS conjunctival isolates.
Raskind
Craig H
CH
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA.
Sabo
Barbara E
BE
Callan
Deborah A
DA
Farrel
Patricia A
PA
Dembry
Louise-Marie
LM
Gallagher
Patrick G
PG
D003229:Conjunctival Diseases / Q000453:epidemiology / Q000382:microbiology*; D003237:Connecticut / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification*; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D018571:Sentinel Surveillance