GONOCOCCAL-INFECTION OF THE NEWBORN IN FLORIDA, 1984-1989

An increase in neonatal gonococcal infections was recorded in Florida between 1984 and 1988. By reviewing Florida sexually transmitted disea se surveillance case records between 1984 and 1989, 68 cases of neonat al gonococcal infections were identified state-wide. Those 68 cases in cluded 55 (81%) cases of gonococcal ophthalmia neonatorum, 4 genital i nfections, 1 nasal infection, 1 ear infection, 1 skin infection, and 1 scalp infection. At birth, positive culture results were demonstrated in 3 gastric and 2 respiratory aspirate cultures. A case-control stud y using birth certificates as the source of information showed that mo thers of infected infants were more likely to be younger, black (odds ratio [OR] = 6.2; 95% confidence interval [CI] 2.3, 16.2), and less ed ucated (less than a high school education, OR = 2.9, CI 1.0, 8.8) in c omparison to mothers of control subjects. Although mothers of infected newborns were less likely to have received prenatal care than were mo thers of control subjects, this difference was not statistically signi ficant. Maternal substance abuse was documented among 19% of the mothe rs of the infected infants. The rate of clinical gonococcal ophthalmia neonatorum in Florida hospitals from which cases had been reported wa s 1.7 per 10,000 live births, and tended to be higher in hospitals usi ng erythromycin than in hospitals using any other prophylactic eye tre atment. This study suggests that the rate of neonatal gonococcal infec tion, in particular ophthalmia neonatorum, may have increased in Flori da among high-risk populations between 1984 and 1988, and underscores the need for targeted prevention efforts and surveillance.