新生兒淋球菌結膜炎之臨床觀察

Clinical Observation of Gonococcal Ophthalmia Neonatorum

吳文豪(Wen-Haur Wu) ； 邱世昌(Shr-Chang Chyou) ； 黃富源(Fu-Yuan Huang) ； 楊定一(Ding-Ie Yang)

《Acta Paediatrica Sinica》 28卷1期 (1987/02) Pp. 11-16

摘要

Thirty cases of gonococcal ophthalmia neonatorum diagnosed since 1975 at Mackay Memorial Hospital were reviewed. Diagnostically, the sensitivity rate between gram stain and culture methods showed no significant statistical difference (P＞0.05). Summer is the peak season. The case number in the past five years increased. Maternal education is mostly in the elementary school level. Males were affected more -frequently than females. Prolonged rupture of membrane, preterm and low-birth weight occupied 26.7%, 10% and 6.7% respectively. Clinically, more cases began to have symptoms within four days of life. They were mostly bilateral, and had purulent discharges in all cases. The only. one case without Credé prophylaxis also suffered from pyogenic arthritis. In our series the first case caused by penicillinase-producing Neisseria gonorrhoeae occurred in 1980. The ratio of resistant strain increased after 1983, and disclosed no statistical difference comparing to that before 1983. The third generation cephalosporin should be emphasized and sensitivity test is required as a guide to therapy, although penicillin was the optimal treatment regimen previously. No ophthalmic sequelae were demonstrated in all cases.
Undoubtedly, every newborn should receive Credé prophylaxis. Once, neonate of mother with gonorrhea develops typical eye symptoms and is proven by gram stain, early treatment is a crucial responsibility of pediatrician.

並列摘要

Thirty cases of gonococcal ophthalmia neonatorum diagnosed since 1975 at Mackay Memorial Hospital were reviewed. Diagnostically, the sensitivity rate between gram stain and culture methods showed no significant statistical difference (P＞0.05). Summer is the peak season. The case number in the past five years increased. Maternal education is mostly in the elementary school level. Males were affected more -frequently than females. Prolonged rupture of membrane, preterm and low-birth weight occupied 26.7%, 10% and 6.7% respectively. Clinically, more cases began to have symptoms within four days of life. They were mostly bilateral, and had purulent discharges in all cases. The only. one case without Credé prophylaxis also suffered from pyogenic arthritis. In our series the first case caused by penicillinase-producing Neisseria gonorrhoeae occurred in 1980. The ratio of resistant strain increased after 1983, and disclosed no statistical difference comparing to that before 1983. The third generation cephalosporin should be emphasized and sensitivity test is required as a guide to therapy, although penicillin was the optimal treatment regimen previously. No ophthalmic sequelae were demonstrated in all cases.
Undoubtedly, every newborn should receive Credé prophylaxis. Once, neonate of mother with gonorrhea develops typical eye symptoms and is proven by gram stain, early treatment is a crucial responsibility of pediatrician.

並列關鍵字

gonococcal ophthalmia neonatorum ； Crede prophylaxis ； penicillinaseproducing Neisseria gonorrhoeae