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Pseudomonas Eye Infection as a Cause of Death in Premature Infants

Pseudomonas Eye Infection as a Cause of Death in Premature Infants Abstract An ophthalmologist encounters many perturbing problems but rarely is faced with a patient whose life is in imminent danger. Such a situation occurs in Pseudomonas aeruginosa (Bacillus pyocyaneus) infection of the eye of the premature infant, a relatively unknown syndrome that is much more common than gonorrheal ophthalmia and greatly outweighs it in gravity. This disease merits the attention of the ophthalmologist. Conjunctivitis in the newborn infant is usually due to one of 4 causes: gonorrheal ophthalmia neonatorum, chemical conjunctivitis from silver nitrate, staphylococcic infection, or inclusion blennorrhea. Of these, the most frequently considered, and rarest, is gonorrheal ophthalmia, the incidence of which is approximately 0.2% without silver nitrate prophylaxis and 0.013% if the Crede method of prophylaxis is used.1 Silver nitrate used for prophylaxis frequently causes conjunctivitis in the treated babies. Recently, staphylococci have been found to be an increasing cause of conjunctivitis, particularly in hospitals where antibiotic References 1. Performed by Arnold Forrest, M.D., Institute of Ophthalmology, New York. 2. Performed by Arnold Forrest, M.D., Institute of Ophthalmology, New York. 3. Mellin, G. W., and Kent, M. P.: Ophthalmia Neonatorum: Is Prophylaxis Necessary? Pediatrics 22:1006-1015, 1958. 4. Wysham, D. N.; Mulhern, M. E.; Navarre, G. C.; LaVeck, G. D.; Kennan, A. L., and Giedt, W. R.: Staphylococcic Infections in an Obstetric Unit: I. Epidemiologic Studies of Pyoderma Neonatorum , New England J. Med. 257; 295-303, 1957.Crossref 5. Farrer, S. M.; Russo, R.; Bavara, C., and Werthamer, S.: Surveillance and Control of Staphylococcic Infections in a Maternity Unit , J.A.M.A. 171:1072-1079, 1959.Crossref 6. Thygeson, P.: Ocular Viral Diseases , M. Clin. North America 43:1419-1440, 1959. 7. Dunham, E. C.: Premature Infants: A Manual for Physicians , New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1955. 8. Nelson, W. E., Editor: Textbook of Pediatrics , Ed. 7, Philadelphia, W. B. Saunders Company, 1959. 9. Hoffman, M. A., and Finberg, L.: Pseudomonas Infections in Infants Associated with High Humidity Environments , J. Pediat. 46:626-630, 1955.Crossref 10. Trimble, G. X.: Otitis Due to Pseudomonas in Newborn Infants , J.A.M.A. 174:209, 1960.Crossref 11. Morbidity and Mortality Weekly Report, National Office of Vital Statistics, May 8, 1959. 12. Breed, R. S.; Murray, E. G. D., and Smith, N. R.: Bergey's Manual of Determinative Bacteriology , Ed. 7, Baltimore, The Williams & Wilkins Company, 1957. 13. Jawetz, E.: Infections with Pseudomonas Aeruginosa Treated with Polymyxin B , A.M.A. Arch. Int. Med. 89:90-98, 1952.Crossref 14. Fisher, E., Jr., and Allen, J. H.: Corneal Ulcers Produced by Cell-Free Extracts of Pseudomonas Aeruginosa , Am. J. Ophth. 46:21-27 ( (July, Pt. 2) ) 1958. 15. Fraenkel, E.: Weitere Untersuchungen über die Menschenpathogenität des Bacillus pyocyaneus , Ztschr. Hyg. 84:369-424, 1917.Crossref 16. Levene, R.: General and Ocular Effects of Endotoxin , Survey Ophth. 4:581-592, 1959. 17. Von Herff: Jahresberichte , Basel, 1903, p. 34 18. Axenfeld, T.: Bacteriology of the Eye , translated by A. Macnab, New York, William Wood & Company, 1908, p. 229. 19. Neter, E., and Weintraub, D. H.: Epidemiologic Study on Pseudomonas Aeruginosa in Premature Infants in Presence and Absence of Infection , J. Pediat. 46:280-287, 1955.Crossref 20. Eggers, H., and Wockel, N.: Zur Klinik und Pathologie der Pyocyaneusinfektion bei Frühgeborenen und Säuglingen , Deutsch. med. Wchnschr. 83:174-180, 1958.Crossref 21. Forkner, C. E.; Frei, E.; Edgcomb, J. H., and Utz, J. P.: Pseudomonas Septicemia: Observations on Twenty-Three Cases , Am. J. Med. 25:877-890, 1958.Crossref 22. Gottsegen, G.: Bacterial Endocarditis Due to Pseudomonas Aeruginosa , J.A.M.A. 168:1929-1930, 1958.Crossref 23. Burns, L. E.; Hodgman, J. E., and Cass, A. B.: Fatal Circulatory Collapse in Premature Infants Receiving Chloramphenicol , New England J. Med. 261:1318-1321, 1959.Crossref 24. Weiss, C. F.; Glazko, A. J., and Weston, J. K.: Chloramphenicol in the Newborn Infant , New England J. Med. 262:787-794, 1960.Crossref 25. Veazie, L. H. (Department of Bacteriology, University of Oregon Medical School): Personal communication to the authors. 26. Erwin, C. P.; Waisbren, B. A., and Kruse, R.: Clinical and Laboratory Studies of Infections Due to Pseudomonas Aeruginosa and Pseudomonas Species , Am. J.M. Sc. 226:525-532, 1953.Crossref 27. Wiggins, R.: Treatment of Pseudomonas Aeruginosa Ulcer with Polymyxin B , A.M.A. Arch. Ophth. 48:522-523, 1952. 28. Hill, E. O.; Altemeier, W. A., and Culbertson, W. R.: An Appraisal of Methods of Testing Bacterial Sensitivity to Antibiotics , Ann. Surg. 148:410-421, 1958.Crossref 29. Latham, S. E. (Medical Department, Burroughs Wellcome & Company, Inc., Tuckahoe, N.Y.): Personal communication to the authors. 30. Silverman, W. A.; Andersen, D. H.; Blanc, W. A., and Crozier, D. N.: A Difference in Mortality Rate and Incidence of Kernicterus Among Premature Infants Allotted to Two Prophylactic Antibacterial Regimes , Pediatrics 18: 614-625, 1956. 31. Kent, S. P.; Tucker, E. S., III, and Taranenko, A.: The Toxicity of Chloramphenicol in Newborns versus Adult Mice , Am. J. Dis. Child. 100:400-404, 1960. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Pseudomonas Eye Infection as a Cause of Death in Premature Infants

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Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1961.01840020519010
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Abstract

Abstract An ophthalmologist encounters many perturbing problems but rarely is faced with a patient whose life is in imminent danger. Such a situation occurs in Pseudomonas aeruginosa (Bacillus pyocyaneus) infection of the eye of the premature infant, a relatively unknown syndrome that is much more common than gonorrheal ophthalmia and greatly outweighs it in gravity. This disease merits the attention of the ophthalmologist. Conjunctivitis in the newborn infant is usually due to one of 4 causes: gonorrheal ophthalmia neonatorum, chemical conjunctivitis from silver nitrate, staphylococcic infection, or inclusion blennorrhea. Of these, the most frequently considered, and rarest, is gonorrheal ophthalmia, the incidence of which is approximately 0.2% without silver nitrate prophylaxis and 0.013% if the Crede method of prophylaxis is used.1 Silver nitrate used for prophylaxis frequently causes conjunctivitis in the treated babies. Recently, staphylococci have been found to be an increasing cause of conjunctivitis, particularly in hospitals where antibiotic References 1. Performed by Arnold Forrest, M.D., Institute of Ophthalmology, New York. 2. Performed by Arnold Forrest, M.D., Institute of Ophthalmology, New York. 3. Mellin, G. W., and Kent, M. P.: Ophthalmia Neonatorum: Is Prophylaxis Necessary? Pediatrics 22:1006-1015, 1958. 4. Wysham, D. N.; Mulhern, M. E.; Navarre, G. C.; LaVeck, G. D.; Kennan, A. L., and Giedt, W. R.: Staphylococcic Infections in an Obstetric Unit: I. Epidemiologic Studies of Pyoderma Neonatorum , New England J. Med. 257; 295-303, 1957.Crossref 5. Farrer, S. M.; Russo, R.; Bavara, C., and Werthamer, S.: Surveillance and Control of Staphylococcic Infections in a Maternity Unit , J.A.M.A. 171:1072-1079, 1959.Crossref 6. Thygeson, P.: Ocular Viral Diseases , M. Clin. North America 43:1419-1440, 1959. 7. Dunham, E. C.: Premature Infants: A Manual for Physicians , New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1955. 8. Nelson, W. E., Editor: Textbook of Pediatrics , Ed. 7, Philadelphia, W. B. Saunders Company, 1959. 9. Hoffman, M. A., and Finberg, L.: Pseudomonas Infections in Infants Associated with High Humidity Environments , J. Pediat. 46:626-630, 1955.Crossref 10. Trimble, G. X.: Otitis Due to Pseudomonas in Newborn Infants , J.A.M.A. 174:209, 1960.Crossref 11. Morbidity and Mortality Weekly Report, National Office of Vital Statistics, May 8, 1959. 12. Breed, R. S.; Murray, E. G. D., and Smith, N. R.: Bergey's Manual of Determinative Bacteriology , Ed. 7, Baltimore, The Williams & Wilkins Company, 1957. 13. Jawetz, E.: Infections with Pseudomonas Aeruginosa Treated with Polymyxin B , A.M.A. Arch. Int. Med. 89:90-98, 1952.Crossref 14. Fisher, E., Jr., and Allen, J. H.: Corneal Ulcers Produced by Cell-Free Extracts of Pseudomonas Aeruginosa , Am. J. Ophth. 46:21-27 ( (July, Pt. 2) ) 1958. 15. Fraenkel, E.: Weitere Untersuchungen über die Menschenpathogenität des Bacillus pyocyaneus , Ztschr. Hyg. 84:369-424, 1917.Crossref 16. Levene, R.: General and Ocular Effects of Endotoxin , Survey Ophth. 4:581-592, 1959. 17. Von Herff: Jahresberichte , Basel, 1903, p. 34 18. Axenfeld, T.: Bacteriology of the Eye , translated by A. Macnab, New York, William Wood & Company, 1908, p. 229. 19. Neter, E., and Weintraub, D. H.: Epidemiologic Study on Pseudomonas Aeruginosa in Premature Infants in Presence and Absence of Infection , J. Pediat. 46:280-287, 1955.Crossref 20. Eggers, H., and Wockel, N.: Zur Klinik und Pathologie der Pyocyaneusinfektion bei Frühgeborenen und Säuglingen , Deutsch. med. Wchnschr. 83:174-180, 1958.Crossref 21. Forkner, C. E.; Frei, E.; Edgcomb, J. H., and Utz, J. P.: Pseudomonas Septicemia: Observations on Twenty-Three Cases , Am. J. Med. 25:877-890, 1958.Crossref 22. Gottsegen, G.: Bacterial Endocarditis Due to Pseudomonas Aeruginosa , J.A.M.A. 168:1929-1930, 1958.Crossref 23. Burns, L. E.; Hodgman, J. E., and Cass, A. B.: Fatal Circulatory Collapse in Premature Infants Receiving Chloramphenicol , New England J. Med. 261:1318-1321, 1959.Crossref 24. Weiss, C. F.; Glazko, A. J., and Weston, J. K.: Chloramphenicol in the Newborn Infant , New England J. Med. 262:787-794, 1960.Crossref 25. Veazie, L. H. (Department of Bacteriology, University of Oregon Medical School): Personal communication to the authors. 26. Erwin, C. P.; Waisbren, B. A., and Kruse, R.: Clinical and Laboratory Studies of Infections Due to Pseudomonas Aeruginosa and Pseudomonas Species , Am. J.M. Sc. 226:525-532, 1953.Crossref 27. Wiggins, R.: Treatment of Pseudomonas Aeruginosa Ulcer with Polymyxin B , A.M.A. Arch. Ophth. 48:522-523, 1952. 28. Hill, E. O.; Altemeier, W. A., and Culbertson, W. R.: An Appraisal of Methods of Testing Bacterial Sensitivity to Antibiotics , Ann. Surg. 148:410-421, 1958.Crossref 29. Latham, S. E. (Medical Department, Burroughs Wellcome & Company, Inc., Tuckahoe, N.Y.): Personal communication to the authors. 30. Silverman, W. A.; Andersen, D. H.; Blanc, W. A., and Crozier, D. N.: A Difference in Mortality Rate and Incidence of Kernicterus Among Premature Infants Allotted to Two Prophylactic Antibacterial Regimes , Pediatrics 18: 614-625, 1956. 31. Kent, S. P.; Tucker, E. S., III, and Taranenko, A.: The Toxicity of Chloramphenicol in Newborns versus Adult Mice , Am. J. Dis. Child. 100:400-404, 1960.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Apr 1, 1961

References