title: Prevalence of gonococcal conjunctivitis in adults and neonates.
abstract: OBJECTIVE
  To report the prevalence of gonococcal conjunctivitis (GC) presenting to a tertiary referral maternity hospital (NMH) and a tertiary referral ophthalmic hospital (RVEEH) from 2011 to 2013 and describe the demographics, clinical presentation, and antibiotic susceptibility of Neisseria gonorrhoeae ocular infections.
  
  
  METHODS
  Demographic, clinical, and microbiological data were collected from patients with laboratory confirmed GC.
  
  
  RESULTS
  There were 27 556 live births at NMH during the study period, and no case of neonatal GC was identified. Fourteen cases of GC were identified at RVEEH in this period, representing a prevalence of 0.19 cases per 1000 eye emergency attendees. Antibiotic susceptibility data were available on nine cases, of which, all were ceftriaxone- and ciprofloxacin sensitive. 64.3% of patients were male, with a mean age of 18 years. The mean duration of symptoms was 3 days. All patients presented with unilateral conjunctival injection and purulent discharge. Eight cases had visual impairment at presentation and their mean visual acuity was 6/15. Corneal involvement was present in 25% of patients. Uveitis was not detected. On receipt of positive culture and/or PCR results, treatment was altered in two thirds of patients. All patients were referred for full STI screening and all patients showed a full clinical recovery 1 week posttreatment.
  
  
  CONCLUSIONS
  We observed that GC presented in young adults with a male predominance and was rare in neonates. In cases of unilateral purulent conjunctivitis, there should be a high clinical suspicion of GC, early swab for PCR and culture, and knowledge of current CDC-recommended antibiotic guidelines.
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: McAnena
authors.affiliation: Department of Microbiology, Royal Victoria Eye and Ear Hospital, National Maternity Hospital, Dublin, Ireland.
authors.forename: S J
authors.initials: SJ
authors.lastname: Knowles
authors.affiliation: Department of Microbiology, National Maternity Hospital, Holles St, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Curry
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Cassidy
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use; D003234:Conjunctivitis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects / Q000302:isolation & purification*; D009878:Ophthalmia Neonatorum / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D009885:Ophthalmology / Q000706:statistics & numerical data; D016133:Polymerase Chain Reaction; D015995:Prevalence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone