Epidemiology and Susceptibility Patterns of Neonatal Conjunctivitis in two Tertiary Care Hospitals in Saudi Arabia

Background: Neonatal conjunctivitis (NC) affects newborns within the first 4 weeks of life and can lead to serious ocular complications and blindness if not treated promptly. The specific organisms responsible for these infections can vary across different populations and clinical settings. The current recommendation is to administer eye ointment prophylaxis to all newborns to prevent NC. Aim: Study the local epidemiology and Susceptibility Patterns of pathogens causing NC and to assess the role of routine prophylaxis. Materials and Methods: This retrospective multicenter cohort study was conducted at two tertiary care centers in Saudi Arabia over 3 years. All neonates with positive eye cultures within the first 28 days of life were included. Results: The total number of NC cases was 244 out of 32,365 live births, which is approximately 754 per 100,000 live births. Staphylococcus aureus (19%) was the most frequently isolated organism, followed by Klebsiella pneumoniae (17%), Escherichia coli (13%), Pseudomonas aeruginosa (11%), Haemophilus influenzae (7%), and Enterobacter cloacae (7%). Only one case of isolated Neisseria gonorrhea was observed. Gentamicin was more than 80% effective against most detected pathogens. Conclusion: NC is a relatively common infection, and healthcare providers can improve patient outcomes by aligning antibiotic recommendations with current microbiological data. Gentamicin is a suitable empirical local antibiotic for NC in our population. Our local data show a scarcity of documented cases of NC caused by gonococcal infection despite no prophylaxis being administered; therefore, routine prophylaxis should be reconsidered.