Rates of chlamydial conjunctivitis drop after CDC screening recommendations

SAN FRANCISCO — In 1993, the CDC recommended routinely screening all pregnant women for Chlamydia trachomatis, or CT, which has significantly reduced the number of neonatal chlamydial conjunctivitis cases in the United States, according to research presented at IDWeek 2018.

“Before the CDC recommendations in 1993, there was no routine screening of pregnant women for chlamydia,” Margaret R. Hammerschlag, MD, professor of pediatrics and medicine and director of the Pediatric Infectious Diseases Fellowship Program at SUNY Downstate Medical Center, told Infectious Diseases in Children. “The best way to reduce prenatal chlamydia infection, which includes pneumonia as well as conjunctivitis, is prenatal screening and treatment.”

To better understand the rates of neonatal chlamydial conjunctivitis before and after this screening was recommended, the researchers conducted a retrospective, observational study of eye samples submitted to the Chlamydia Research Laboratory at SUNY Downstate.

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Hammerschlag and colleagues identified 880 samples from infants with signs and symptoms of conjunctivitis that were sent for CT testing. Of these samples, 11.7% were positive. The researchers note that over time, the prevalence of positive cultures decreased.

Between 1986 and 1993 — before screening was recommended — 15.6% of cultures were positive for CT. This percentage decreased to 1.8% once screening was recommended (1994-2002).

According to Hammerschlag and colleagues, high rates of screening were confirmed through a separate hospital audit, which revealed that more than 95% of pregnant women were screened for CT.

“Anecdotally, we have seen only one case of neonatal chlamydial conjunctivitis at our institution during the past 20 years,” Hammerschlag said. “Before screening, we would see 20 to 30 cases per year.” – by Katherine Bortz

Reference:

Banniettis N, et al. Abstract 608. Presented at: IDWeek 2018; October 3-7, 2018; San Francisco, CA.

Disclosures: The authors report no relevant financial disclosures.