Declining incidence of neonatal endophthalmitis in the United States.
OBJECTIVE
To determine the incidence of neonatal endogenous endophthalmitis in the United States between 1998 and 2006 and to identify associated risk factors.


METHODS
Retrospective cohort study.


METHODS
We used the Nationwide Inpatient Sample database, a 20% representative sample of all hospital discharges in the United States, to help refine our understanding of this condition. International Classification of Diseases, ninth edition, codes for endophthalmitis, sepsis, and suspected endophthalmitis risk factors in hospitalized infants and neonates were searched in the database and were tracked over time. The main outcome measure was incidence of neonatal endophthalmitis over the study period.


RESULTS
Of 3.64 million live births in 1998, 317 newborns were identified with endophthalmitis (8.71 cases per 100 000 live births). Of 4.14 million live births in 2006, only 183 newborns were identified with endophthalmitis (4.42 cases per 100 000 live births) by comparison. The incidence of endophthalmitis decreased at a rate of 6% per year (P = .01130) between 1998 and 2006. Neonates with endophthalmitis were more likely to have systemic bacteremia (odds ratio, 21.114; P < .0001), Candidemia (odds ratio, 2.356; P < .0001), a birth weight of less than 1500 g (odds ratio, 1.215; P < .0001), and retinopathy of prematurity (odds ratio, 2.052; P < .0001).


CONCLUSIONS
We objectively validated the commonly held belief that Candidemia, bacteremia, retinopathy of prematurity, and low birth weight are significant risk factors for endophthalmitis development in infants, which seems to have had a decreasing incidence in recent years.
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida, USA.
Andrew A
AA
Moshfeghi
Resmi A
RA
Charalel
Tina
T
Hernandez-Boussard
John M
JM
Morton
Darius M
DM
Moshfeghi
D016470:Bacteremia / Q000453:epidemiology; D001724:Birth Weight; D058387:Candidemia / Q000453:epidemiology; D016208:Databases, Factual; D009877:Endophthalmitis / Q000453:epidemiology*; D005260:Female; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D016017:Odds Ratio; D012178:Retinopathy of Prematurity / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology