新生児結膜炎の感染源の検索

Etiological analysis of neonatal conjunctivitis

　新生児結膜炎の感染源を検索するために，母体の子宮頸部およびその新生児の結膜から細菌，クラミジア，真菌，ウイルスの検索を行うと共に新生児結膜炎患者の結膜の病因的検索を行い，次のごとき結論を得た．

　①新生児結膜炎の病因は細菌とクラミジアが主体であり，真菌とウイルスは稀である．

　②クラミジア性結膜炎は偽膜性であり，病因細菌は抗生物質に耐性を示す頻度が高い．

　③新生児結膜炎の治療にはエリスロマイシン（EM），ゲンタマイシン（GM）などの抗クラミジア剤と耐性ブドウ球菌に効果のある抗生物質の併用を必要とする．

　④新生児期から乳幼児期にかけてはtransitfloraであり，正常の結膜細菌叢は7歳以降に完成する．

In order to clarify the etiological factors of neonatal conjunctivitis, we attempted to isolate infectious organ-isms from the cervix of 97 prospective mothers one week before delivery, the conjunctival sac of 91 new-born babies one week after birth and from 69 newborn babies with active conjunctivitis.

We could confirm that fungal and viral organisms played a negligible etiological role in neonatal conjunc-tivitis. Chlamydia trachomatis and antibiotics-resistant staphylococcal strains were the chief agents in the conjunctival flora of normal or infected babies. It appeared that the chlamydia trachomatis was vertically transmitted from the mother to the baby and that the antibiotics-resistant staphylococci were horizontally infected as a hospital-acquired infection.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(6) : 681-684,1986