Complications of conjunctivitis caused by Pseudomonas aeruginosa in a newborn intensive care unit

Background. In infancy Pseudomonas aeruginosa conjunctivitis may lead to a rapidly progressive invasive eye infection. In some cases this destructive eye disease is associated with or followed by infection at other sites. We observed seven hospitalized infants with P. aeruginosa conjunctivitis who developed systemic complications of P. aeruginosa infection without evidence of invasive eye disease, prompting us to examine the characteristics of this infection and its associated systemic complications in hospitalized infants. Methods. We reviewed retrospectively the course, treatment and outcome of infants with nonepidemic P. aeruginosa conjunctivitis in the Newborn Special Care Unit at Yale-New Haven Hospital during a 10-year period from November 1, 1986, to October 31, 1996. Results. Eighteen infants with P. aeruginosa conjunctivitis had mean birth weights and gestational ages of 29.3 weeks and 1380 g, respectively. The average postnatal age at onset of P. aeruginosa conjunctivitis was 17 days. No infant had invasive eye disease, Systemic complications occurred in seven (39%) infants and included bac-teremia, meningitis, brain abscess and death, Infants who developed systemic complications had lower mean birth weights (850 g us. 1716 g, P = 0.04) and lower mean gestational ages (26.4 us. 31.2 weeks, P = 0.02) than infants who did not. Six of seven infants weighing <1000 g developed systemic complications; two of these infants died. Conclusions. In hospitalized infants P. aeruginosa conjunctivitis may be associated with systemic complications with or without invasive eye infection, emphasizing the need for early detection and treatment of this infection in this population.