title: Incidence, Etiology and Risk Factors Associated with Neonatal Healthcare-Associated Conjunctivitis: A Prospective Study from a Tertiary Care Hospital in India.
abstract: BACKGROUND
  Healthcare-associated conjunctivitis (HAC) can lead to serious sequelae including blindness. We conducted a one-year prospective study to determine the epidemiology of neonatal HAC at a tertiary-care hospital in India.
  
  
  METHODS
  From the neonates fulfilling a set of predefined inclusion criteria, cases of HAC were diagnosed based on CDC guidelines. Conjunctival swabs, obtained from neonates with suggestive clinical signs, were processed using standard protocols. Twenty-eight potential risk factors were analyzed.
  
  
  RESULTS
  We detected 24 cases of HAC among 591 enrolled neonates, with Escherichia coli being the most frequently isolated microorganism. On multivariate analysis, intubation at birth (p = 0.046) and orogastric feeding (p = 0.029) had a statistically significant association with neonatal HAC. Average hospitalization increased from 9.6 to 20.8 days for neonates diagnosed with HAC.
  
  
  CONCLUSIONS
  A standardized case-definition and physician awareness of potential serious sequelae would help improve detection rates and timely institution of therapy. Hand hygiene could help control the menace of neonatal HAC.
authors.affiliation: Department of Microbiology, Lady Hardinge Medical College and associated Smt. Sucheta Kriplani Hospital, New Delhi, 110001, India Department of Medicine, University of Kentucky, KY 40536, USA drkanikagoel@gmail.com.
authors.forename: Kanika
authors.initials: K
authors.lastname: Goel
authors.affiliation: Department of Microbiology, Lady Hardinge Medical College and associated Smt. Sucheta Kriplani Hospital, New Delhi, 110001, India.
authors.forename: Valinderjeet Singh
authors.initials: VS
authors.lastname: Randhawa
authors.affiliation: Department of Neonatology, Lady Hardinge Medical College, New Delhi, 110001, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Saili
authors.affiliation: Division of Microbiology, National Centre for Disease Control, New Delhi, 110054, India.
authors.forename: Shashi
authors.initials: S
authors.lastname: Khare
authors.affiliation: Department of Neonatology, Lady Hardinge Medical College, New Delhi, 110001, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Microbiology, Lady Hardinge Medical College and associated Smt. Sucheta Kriplani Hospital, New Delhi, 110001, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Dutta
authors.affiliation: Department of Medicine, University of Kentucky, KY 40536, USA.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Goel
mesh_terms: D002648:Child; D003234:Conjunctivitis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D063128:Tertiary Health Care
keywords: conjunctivitis; healthcare-associated conjunctivitis; healthcare-associated infections; neonates; nosocomial