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Margaret R. Hammerschlag - One of the best experts on this subject based on the ideXlab platform.
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Neonatal prophylaxis with antibiotic containing ointments does not reduce incidence of Chlamydial Conjunctivitis in newborns
BMC Infectious Diseases, 2021Co-Authors: Tamar A. Smith-norowitz, Crystal Ukaegbu, Stephan Kohlhoff, Margaret R. HammerschlagAbstract:Background Neonatal ocular prophylaxis with silver nitrate does not prevent neonatal Conjunctivitis due to Chlamydia trachomatis . The efficacy of antibiotic containing preparations for prevention of neonatal Chlamydial Conjunctivitis (NCC) has not been established. Objective To examine published literature to determine whether antibiotic containing preparation are efficacious for prevention of NCC and C. trachomatis in the nasopharynx. Methods A literature search of MEDLINE and EMBASE. Articles were selected for review if their content included 4 key criteria: (1) Prospective/comparative study. (2) Prenatal screening of mothers for C. trachomatis with results reported. (3) Follow-up of infants born to chlamydia-positive women. (4) Infants prospectively followed at regular intervals and tested for C. trachomatis in the eye/ nasopharynx (NP). Results The search yielded 159 studies; 11 were selected for full reviews, eight were excluded; three addressed the four criteria. Rates of C. trachomatis Conjunctivitis in infants in included studies who received silver nitrate was 20–33%; positive NP, 1–28% and pneumonia, 3–8%. Rates of C. trachomatis Conjunctivitis in neonates who received erythromycin or tetracycline prophylaxis did not differ from silver nitrate; 0–15 and 11%, respectively, who received erythromycin or tetracycline developed NCC. Similarly, 4–33 and 5% of infants who received erythromycin or tetracycline, respectively, had positive NP cultures; 0–4% developed Chlamydial pneumonia. Conclusion Neonatal ocular prophylaxis with erythromycin or tetracycline ophthalmic ointments does not reduce incidence of neonatal Chlamydial Conjunctivitis or respiratory infection in infants born to mothers with C. trachomatis infection compared to silver nitrate.
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evaluation of a new optical immunoassay for diagnosis of neonatal Chlamydial Conjunctivitis
Journal of Clinical Microbiology, 1997Co-Authors: Patricia M. Roblin, Maureen Gelling, Andrei Kutlin, Naoki Tsumura, Margaret R. HammerschlagAbstract:The BioStar OIA Chlamydia test (BioStar, Inc., Boulder, Colo.) is a novel immunoassay system that uses changes in reflection of light to directly detect Chlamydial antigen in clinical specimens. We compared the optical immunoassay (OIA) with culture for detecting Chlamydia trachomatis in ocular specimens from infants with suspected Chlamydial Conjunctivitis. We initially performed a retrospective evaluation, testing 152 ocular specimens previously collected for culture with the OIA. The sensitivity and specificity were 94.2 and 97%, respectively. A subsequent prospective study evaluating 37 ocular specimens from infants with suspected C. trachomatis Conjunctivitis revealed a sensitivity and specificity of 100 and 92.6%, respectively.
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Comparison of a chemiluminometric immunoassay with culture for diagnosis of Chlamydial infections in infants
Journal of clinical microbiology, 1992Co-Authors: Wilson Dumornay, Margaret R. Hammerschlag, Maureen Gelling, Patricia M. Roblin, Mosisa WorkuAbstract:The performance of Magic Lite (CIBA-Corning), a chemiluminescent immunoassay (CIA), was compared with that of culture for the diagnosis of neonatal Chlamydial Conjunctivitis and respiratory infection. We performed a retrospective evaluation of 51 ocular and 96 nasopharyngeal specimens previously collected for culture testing with the CIA. The sensitivities for the ocular and the nasopharyngeal specimens were 91 and 91.7%, respectively. The specificities for both sites were 100%. A subsequent prospective study evaluating 71 ocular and 38 nasopharyngeal specimens revealed sensitivities of 83.3 and 20%, respectively. The specificities for both sites were 100%. The CIA performed favorably, compared with culture, for the diagnosis of Chlamydial Conjunctivitis; however, the CIA appeared less sensitive for the diagnosis of respiratory infection, including pneumonia.
Jay S. Pepose - One of the best experts on this subject based on the ideXlab platform.
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Comparative Diagnosis of Neonatal Chlamydial Conjunctivitis by Polymerase Chain Reaction and McCoy Cell Culture
American Journal of Ophthalmology, 2014Co-Authors: Audrey R. Talley, Francisco J. Garcia-ferrer, Keith A. Laycock, Lydia R. Essary, William L. Holcomb, Brian Flowers, Michael J. Loeffelholz, Carol Lewinski, Jay S. PeposeAbstract:Cervical and ocular swabs from 100 mother/newborn pairs delivering on the clinic service were assayed for Chlamydia trachomatis with standard McCoy cell culture and with standard and biotinylated polymerase chain reaction techniques, using primers directed against the major outer membrane protein gene and C. trachomatis -specific cryptic plasmid, respectively. Using the polymerase chain reaction, 20 (20%) mothers and seven (7%) neonates were positive for Chlamydia. All neonates positive by polymerase chain reaction were from mothers positive by polymerase chain reaction, yielding a 35% transmission rate. Only five of 20 (25%) mothers and two of seven (28%) neonates positive by polymerase chain reaction were positive by cell culture. All cell culture samples were positive by polymerase chain reaction testing. Culture and polymerase chain reaction analysis two weeks after treatment with oral erythromycin were negative. The polymerase chain reaction assay appears to be equally specific and more sensitive than McCoy cell culture for the detection of C. trachomatis from ocular specimens.
Nancy G Berman - One of the best experts on this subject based on the ideXlab platform.
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a controlled trial of povidone iodine to treat infectious Conjunctivitis in children
American Journal of Ophthalmology, 2002Co-Authors: Sherwin J. Isenberg, Leonard Apt, Mario Valenton, Madeline Del Signore, Leo Dp Cubillan, Maria A Labrador, Pauline Chan, Nancy G BermanAbstract:Abstract PURPOSE: To report the efficacy of povidone-iodine as a treatment for Conjunctivitis in pediatric patients. DESIGN: Double-masked, controlled, prospective clinical trial. METHODS: In an ophthalmology clinic in a general hospital in Manila, Philippines, 459 children (mean [SD] age 6.6 [6.6] years; range, 7 months-21 years) with acute Conjunctivitis were studied. Infected eyes were cultured for bacteria and underwent immunofluorescent testing for Chlamydia trachomatis. Viral Conjunctivitis was diagnosed if bacterial cultures were negative and diagnostic criteria were met. Subjects were alternated to receive povidone-iodine 1.25% or neomycin-polymyxin-B-gramicidin ophthalmic solution, one drop 4 times daily in the affected eye. Ocular inflammation was evaluated daily by the family or patient and weekly by an ophthalmologist. The main outcome measures were days until cured and proportion cured after 1 and 2 weeks of treatment. RESULTS: Despite adequate statistical power (power >80% for a 1-day difference and P CONCLUSIONS: Povidone-iodine 1.25% ophthalmic solution was as effective as neomycin-polymyxin B-gramicidin for treating bacterial Conjunctivitis, somewhat more effective against chlamydia, and as ineffective against viral Conjunctivitis. Povidone-iodine ophthalmic solution should be strongly considered as treatment for bacterial and Chlamydial Conjunctivitis, especially in developing countries where topical antibiotics are often unavailable or costly.
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a controlled trial of povidone iodine to treat infectious Conjunctivitis in children
American Journal of Ophthalmology, 2002Co-Authors: Sherwin J. Isenberg, Leonard Apt, Mario Valenton, Madeline Del Signore, Leo Dp Cubillan, Maria A Labrador, Pauline Chan, Nancy G BermanAbstract:Abstract PURPOSE: To report the efficacy of povidone-iodine as a treatment for Conjunctivitis in pediatric patients. DESIGN: Double-masked, controlled, prospective clinical trial. METHODS: In an ophthalmology clinic in a general hospital in Manila, Philippines, 459 children (mean [SD] age 6.6 [6.6] years; range, 7 months-21 years) with acute Conjunctivitis were studied. Infected eyes were cultured for bacteria and underwent immunofluorescent testing for Chlamydia trachomatis . Viral Conjunctivitis was diagnosed if bacterial cultures were negative and diagnostic criteria were met. Subjects were alternated to receive povidone-iodine 1.25% or neomycin-polymyxin-B-gramicidin ophthalmic solution, one drop 4 times daily in the affected eye. Ocular inflammation was evaluated daily by the family or patient and weekly by an ophthalmologist. The main outcome measures were days until cured and proportion cured after 1 and 2 weeks of treatment. RESULTS: Despite adequate statistical power (power >80% for a 1-day difference and P P = .133–.824 for the four comparisons). After 1 week of treatment, povidone-iodine cured marginally more Chlamydial infections than the antibiotic ( P = .057). By 2 weeks, fewer Chlamydial infections were cured than those of viral or bacterial etiology ( P = .0001). The younger the patient, the faster their Conjunctivitis resolved (R = 0.13, P = .013). CONCLUSIONS: Povidone-iodine 1.25% ophthalmic solution was as effective as neomycin-polymyxin B-gramicidin for treating bacterial Conjunctivitis, somewhat more effective against chlamydia, and as ineffective against viral Conjunctivitis. Povidone-iodine ophthalmic solution should be strongly considered as treatment for bacterial and Chlamydial Conjunctivitis, especially in developing countries where topical antibiotics are often unavailable or costly.
Patricia M. Roblin - One of the best experts on this subject based on the ideXlab platform.
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evaluation of a new optical immunoassay for diagnosis of neonatal Chlamydial Conjunctivitis
Journal of Clinical Microbiology, 1997Co-Authors: Patricia M. Roblin, Maureen Gelling, Andrei Kutlin, Naoki Tsumura, Margaret R. HammerschlagAbstract:The BioStar OIA Chlamydia test (BioStar, Inc., Boulder, Colo.) is a novel immunoassay system that uses changes in reflection of light to directly detect Chlamydial antigen in clinical specimens. We compared the optical immunoassay (OIA) with culture for detecting Chlamydia trachomatis in ocular specimens from infants with suspected Chlamydial Conjunctivitis. We initially performed a retrospective evaluation, testing 152 ocular specimens previously collected for culture with the OIA. The sensitivity and specificity were 94.2 and 97%, respectively. A subsequent prospective study evaluating 37 ocular specimens from infants with suspected C. trachomatis Conjunctivitis revealed a sensitivity and specificity of 100 and 92.6%, respectively.
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Evaluation of a New Optical Immunoassay for Diagnosis of Neonatal Chlamydial Conjunctivitis
1996Co-Authors: Patricia M. Roblin, Maureen Gelling, Andrei Kutlin, Naoki Tsumura, R. HammerschlagAbstract:changes in reflection of light to directly detect Chlamydial antigen in clinical specimens. We compared the optical immunoassay (OIA) with culture for detecting Chlamydia trachomatis in ocular specimens from infants with suspected Chlamydial Conjunctivitis. We initially performed a retrospective evaluation, testing 152 ocular specimens previously collected for culture with the OIA. The sensitivity and specificity were 94.2 and 97%, respectively. A subsequent prospective study evaluating 37 ocular specimens from infants with suspected C. trachomatis Conjunctivitis revealed a sensitivity and specificity of 100 and 92.6%, respectively. Chlamydia trachomatis is the most common identifiable in-fectious cause of neonatal Conjunctivitis (3–5, 7, 8). Approxi-mately 20 to 40 % of the cases of neonatal Conjunctivitis seen at our institution are caused by C. trachomatis (3–5, 8). Previous studies of enzyme immunoassays and direct fluorescent anti-body tests (DFA) in infants with Chlamydial Conjunctivitis have found sensitivities and specificities usually exceeding 92 % (3–5, 7, 8). The BioStar OIA Chlamydia test (BioStar, Inc., Boulder
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Comparison of a chemiluminometric immunoassay with culture for diagnosis of Chlamydial infections in infants
Journal of clinical microbiology, 1992Co-Authors: Wilson Dumornay, Margaret R. Hammerschlag, Maureen Gelling, Patricia M. Roblin, Mosisa WorkuAbstract:The performance of Magic Lite (CIBA-Corning), a chemiluminescent immunoassay (CIA), was compared with that of culture for the diagnosis of neonatal Chlamydial Conjunctivitis and respiratory infection. We performed a retrospective evaluation of 51 ocular and 96 nasopharyngeal specimens previously collected for culture testing with the CIA. The sensitivities for the ocular and the nasopharyngeal specimens were 91 and 91.7%, respectively. The specificities for both sites were 100%. A subsequent prospective study evaluating 71 ocular and 38 nasopharyngeal specimens revealed sensitivities of 83.3 and 20%, respectively. The specificities for both sites were 100%. The CIA performed favorably, compared with culture, for the diagnosis of Chlamydial Conjunctivitis; however, the CIA appeared less sensitive for the diagnosis of respiratory infection, including pneumonia.
Andrew Zikic - One of the best experts on this subject based on the ideXlab platform.
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treatment of neonatal Chlamydial Conjunctivitis a systematic review and meta analysis
Journal of the Pediatric Infectious Diseases Society, 2018Co-Authors: Andrew Zikic, Holger J Schunemann, Ornella Lincetto, Nathalie Broutet, Nancy SantessoAbstract:Background With the continued high prevalence of chlamydia worldwide and high risk of transfer from mothers to their infant during delivery, a need for safe and effective therapies for infants who acquire a Chlamydial infection remains. We conducted a systematic review and meta-analysis of antibiotic treatments, including oral erythromycin, azithromycin, and trimethoprim, for neonatal Chlamydial Conjunctivitis. Methods We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from their inception to July 14, 2017. We included randomized and nonrandomized studies that evaluated the effects of erythromycin, azithromycin, or trimethoprim in neonates with Chlamydial Conjunctivitis. A meta-analysis using a random-effects generic inverse-variance method was performed, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results We found 12 studies (n = 292 neonates) and were able to meta-analyze 7 studies that used erythromycin at a dose of 50 mg/kg body weight per day for 14 days. The clinical and microbiological cure were 96% (95% confidence interval [CI], 94%-100%) and 97% (95% CI, 95%-99%), respectively, and adverse gastrointestinal effects occurred in 14% (95% CI, 1%-28%) of the neonates. The microbiological cure in the study that assessed azithromycin at 20 mg/kg per day were 60% (95% CI, 27%-93%) when it was given in a single dose and 86% (95% CI, 61%-100%) when given in a 3-day course. Two studies reported compliance with treatments, and 1 study reported no pyloric stenosis events. Because of the risk of bias and the few neonates included across the studies, the certainty of evidence is low to very low. No studies assessed trimethoprim. Conclusions Although evidence suggests that erythromycin at 50 mg/kg per day for 14 days results in higher numbers of cure than does azithromycin, compliance and risk of pyloric stenosis related to their use for other infections in neonates will factor into treatment recommendations. More data are needed to compare these treatments directly.
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systemic antibiotics for the treatment of neonatal Chlamydial Conjunctivitis a systematic review
Global Health: Annual Review, 2015Co-Authors: Andrew ZikicAbstract:Background: Chlamydia trachomatis is the most common cause of neonatal Conjunctivitis 1 . Safe and effective therapies in addition to proper prophylactic strategies are needed for neonatal Chlamydial Conjunctivitis. Objective: To conduct a systematic review of the effects of oral erythromycin, azithromycin and trimethoprim antibiotics for the treatment of neonatal Chlamydial Conjunctivitis. Search Strategy : We searched Medline, Embase, and CENTRAL up to May 10 th 2015, did not restrict by language or study type and reviewed reference lists of relevant studies, guidelines, and systematic reviews. Selection Criteria : Randomised controlled trials or non-randomised studies that assessed the effects of treatment of neonatal Chlamydial Conjunctivitis using erythromycin, azithromycin or trimethoprim antibiotics. Data Collection & Analysi s: Two independent investigators collected, extracted and analyzed data. Risk of bias and quality of evidence according to GRADE were determined. Results: We included a total of 9 studies of (2 randomised & 7 non-randomised). Quality of evidence as a result of publication bias and imprecision was either low or very low. Combined event rates for clinical and microbiological cure using the most common treatment dosage, erythromycin 50 mg/kg per day for 14 days, was 125/130 (96.2%). Azithromycin clinical and microbiological cure rate was 60% for a 20mg/kg per day as a single dose and 85.7% for 20 mg/kg/d for 3 days. The most frequent complication was nasopharyngeal co-infection observed in about 22.7% to 57.6% of cases depending on the dosage. Side effects included gastrointestinal disturbances with a range of 7.1% to 42.9% depending on the dosage regimen. None of the studies found assessed trimethoprim. Conclusions: We provide a comprehensive summary of the efficacy, complications and side effects of current treatments for neonatal Conjunctivitis.However, more research is needed using higher quality randomised controlled trials in order to better assess current treatment practices and test newer antibiotics that may have easier dosage regimens and less side effects.