Microbiota anaeróbia e facultativa da conjuntiva normal de recém-nascidos

Farah, Ana Luisa Höfling de Lima; Santos, Manoel Antônio de Azevedo; Belfort, Rubens; Cabral, José Henrique; Mós, Eduardo Nascimento; Farah, Michel Eid

doi:10.5935/0004-2749.19930038

RESUMO

Para o estudo da microbiota anaeróbia e facultativa da conjuntiva normal de recém-nascidos no período neonatal, 193 amostras da secreção do fundo de saco conjuntival foram obtidas.

Durante o período neonatal os recém-nascidos foram divididos em três grupos: I - recém-nascidos imediatamente após o parto; II - do nascimento até 15 dias de vida; III - recém-nascidos entre 15 e 28 dias de vida.

Cento e sessenta e sete amostras apresentaram crescimento bacteriano positivo, sendo isolados 183 microrganismo num total de 12 espécies bacterianas. Entre as bactérias facultativas, Staphylococcus aureus foi o microrganismo isolado mais freqüente e entre os anaeróbios Bacteroides sp.

Em todos os grupos, Staphylococcus aureus foi o microrganismo mais freqüente. Bactérias anaeróbias obrigatórias foram isoladas em maior freqüência no terceiro grupo. Foi demonstrado maior número de culturas positivas e isolamento de S. aureus em recém-nascidos de parto normal e com ruptura das membranas.

O presente estudo demonstra a existência de uma flora conjuntival normal e facultativa durante o período neonatal, revelando que a colonização começa imediatamente após o nascimento e o número de culturas positivas está relacionado com o tempo de exposição individual.

Palavras-chave:
Staphylococcus aureus na conjuntiva; cultura da conjuntiva; conjuntiva de recém-nascidos; flora anaeróbia; flora facultativa; microbiota anaeróbia e facultativa

SUMMARY

One hundred and ninety three samples from the conjuntival fornices of newborns during neonatal period were obtained and cultured to study the conjuntival anaerobic and facultative microbial normal flora.

During the neonatal period the newborns were divided in three groups: I - including newborns immediately after birth; II - from birth up to 15 days; III - newborns up to 28 days. In all those groups S. aureus was the most frequent microorganism isolated.

From 167 positive samples, 183 positive isolated bacteria were obtained. The total of 12 different bacteria species were identified with a predominance of facultative anaerobic bacteria. Among the facultative bacteria, Staphylococcus aureus was the most frequent, and Bacteroides sp was the most frequent among the anaerobic bacteria.

An increase of positive cultures with anaerobic bacteria was observed in the third group. It was demonstrated that there is a higher number of positive cultures with S. aureus isolation in newborns with (normal) delivery and with rupture of the membrane.

The present study demonstrated normal anaerobic and facultative conjuntival normal flora during neonatal period and revealed that the colonization started immediately after birth, and the number of positive cultures is related to the time of individual exposure.

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
Brook, I. - Anaerobic bacleria in pediatric infections. Am. Fam. Physician., 23: 201-4, 1981.
²
Brook, I. - Microbiology of neonatal conjunclivitis: the role of anaerobes. J. Pediatr., 107(1): 159-60, 1985.
³
Brook, I.; Barrett, C.T.; Brinkman III, C.R.; Martin, W.J.; Finegold, S.M. - Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva: a prospective study. Pediatrics, 63: 451-5, 1979a.
⁴
Campos, M.S.Q.; Salo, E.H.; Nose, W.; Mós, E.N.; Santos, M.A.A. - Microbiota anaeróbia do saco conjuntival humano normal. Arq. Bras. Oftalmol., 1989, no prelo.
⁵
Cason, L. & Winkler, C.H. - Bacteriology of the eye: normal flora. Arch. Ophthalmol., 51: 196-9, 1954.
⁶
Davies, P.A. & Gothefors, L.A. - Bacterial infections in the fetus and newborn infant Philadelphia, W.B. Saunders Co, 1984. p. 184-5.
⁷
Fildes, P. - Tetanus IX the oxidation-reduction potential of the subcutaneous. Tissue fluid of the guineapig: its effects on infection. Br. J. Exp. Pathol, 10: 197-204, 1929.
⁸
Grunberger V. & Kofler, E. - Uber den keimgehalf der kindlichen Conjuntiva nachderGeburt. Gynakologe, 137: 329,1954.
⁹
Holdeman, L.V. & Moore, W.E.C. - Anaerobe laboratory, 4. ed. Virgínia, 1979. 152p.
¹⁰
Isenberg, S.J.; Apt, L.; Yoshimori, R.; McCarty, J.W.; Alvarez, S.R. - Source of the conjunctival baclerial flora at birthand implications forophthal- neonatorum prophylaxis. Am. J. Ophthalmol., 106. 458-62,1988.
¹¹
Isenberg, S.J.; Apt, L.; Yoshinori, R.; Alvarez, S.R. - Bacterial flora of the conjuntiva at birth. J. Pediatr. Ophthalmol. Strabismus., 6: 284, 1986.
¹²
Jones, D.B. & Robinson, N.M. - Anaerobic ocular infection. Trans. Am. Ophthalmol., 83: 309-29, 1977.
¹³
Khorazo, D. & Thompson, R. - The bacterial flora of the normal conjunctiva. Arch. Ophthalmol., 18: 1114-6,1935.
¹⁴
Lawson, A. -The bacteriology of the normal conjuntival sac and its practical bearing on the utility of antiseptics in ophthalmic surgery. Br. Med. J., 2: 486-7, 1898.
¹⁵
Locather-Khorazo, D. & Gutierrez, E.H. - The bacterial flora of the healthy eye. ln: Locather-Khorazo, D. & Segal, B.C. - Microbiology of the eye. St. Louis, Mosby, 1972, p. 13-23.
¹⁶
Matuura, H. - Anaerobes in The bacterial flora of The conjunctival sac. Jpn. J. Ophthalmol., 15: 116-24, 1971.
¹⁷
Molgaard, I-L; Nielsen, P.B.; Kaern, J - A study of The incidence of neonatal conjunctivitis and of its bacterial causes including Chlamydia trachomatis. Acta Ophthal., 62: 461-71, 1984.
¹⁸
Ostler, H.B.; Okumoto, M. - Anaerobicstreptococcal corneal ulcer. Am. J. Ophthalmol., 81: 379-560, 1976.
¹⁹
Perkins, R.F.; Kundsin, R.B.; Pratt, M. V.; Abrahamsen, I.; Leibowitz, H.M. - Bacteriology of normal andinfectedconjuntiva.J. Clin. Microbiol., 1: 147-9,1975.
²⁰
Perry, L.D.; Brinser, I.H.; Kolodner, H. - Anaerobic corneal ulcere. Ophthalmology, 89: 639-42, 1982.
²¹
Pierce, I.M.; Ward, M.E.; Seal, D.V. - Ophthalmia neonatorum in the 1980s: incidence, etiology and treatment. Br. J. Ophthalmol., 66: 728-31, 1982.
²²
Prentice, M.J.; Hutchinson, G.R; Taylor-Robinson, D. - Amicrobiological study of neonatal conjunctivae and conjunctivitis. Br. J. Ophthalmol., 61: 601-7,1977.
²³
Rapoza, P.A.; Quinn, C.T.; Kiessling, L.A.; Taylor, H.R. - Epidemiology of neonatal conjunctivitis. Ophthalmology, 93: 456-61, 1986.
²⁴
Reeder, J.C.; Westwel, A.I.; Hutchinson, D.N. - Indifferent Streptococci innormal and purulenteyes of neonates. J. Clin. Pathol., 38: 942-5, 1985.
²⁵
Rosenblatt, J.E. & Stewart, P.R. - Anaerobic bag culturemethod. J. Clin. Microbiol., 1: 527-30,1975.
²⁶
Rotimi, V.O. & Duerden, B.I. - The development of the bacterial flora in normal neonates. J. Med. Microbiol., 14: 51-62, 1981.
²⁷
Sandstrom, I. - Etiology and diagnosis of neonatal conjunctivitis. Acta Paediatr. Scand., 76: 221-7.
²⁸
Sandstrom, K.I.; Beel, T.A.; Chandler, I.W.; Kuo, C.C.; Wang, S-P; Grayston, I.T.; Foy, H.M.; Stamm, W.E.; Cooney, M.K.; Smith, A.L., Holmes, K.K. - Microbial causes of neonatal conjunctivitis. J. Pediatr., 105: 706-10, 1984.
²⁹
Smith, R.E. - Inflamation after cataract surgery: editorial. Am. J. Ophthalmol., 102: 788-90,1986.
³⁰
Sutter, V.L.; Citron, D.M.; Finegold, S.M. - Anaerobic bacterology manual. 3.ed. St. Louis, C.V. Mosby Company, 1980. 131p.

Datas de Publicação

Publicação nesta coleção
Jun 1993

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
Brook, I. - Anaerobic bacleria in pediatric infections. Am. Fam. Physician., 23: 201-4, 1981.

[2] ²
Brook, I. - Microbiology of neonatal conjunclivitis: the role of anaerobes. J. Pediatr., 107(1): 159-60, 1985.

[3] ³
Brook, I.; Barrett, C.T.; Brinkman III, C.R.; Martin, W.J.; Finegold, S.M. - Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva: a prospective study. Pediatrics, 63: 451-5, 1979a.

[4] ⁴
Campos, M.S.Q.; Salo, E.H.; Nose, W.; Mós, E.N.; Santos, M.A.A. - Microbiota anaeróbia do saco conjuntival humano normal. Arq. Bras. Oftalmol., 1989, no prelo.

[5] ⁵
Cason, L. & Winkler, C.H. - Bacteriology of the eye: normal flora. Arch. Ophthalmol., 51: 196-9, 1954.

[6] ⁶
Davies, P.A. & Gothefors, L.A. - Bacterial infections in the fetus and newborn infant Philadelphia, W.B. Saunders Co, 1984. p. 184-5.

[7] ⁷
Fildes, P. - Tetanus IX the oxidation-reduction potential of the subcutaneous. Tissue fluid of the guineapig: its effects on infection. Br. J. Exp. Pathol, 10: 197-204, 1929.

[8] ⁸
Grunberger V. & Kofler, E. - Uber den keimgehalf der kindlichen Conjuntiva nachderGeburt. Gynakologe, 137: 329,1954.

[9] ⁹
Holdeman, L.V. & Moore, W.E.C. - Anaerobe laboratory, 4. ed. Virgínia, 1979. 152p.

[10] ¹⁰
Isenberg, S.J.; Apt, L.; Yoshimori, R.; McCarty, J.W.; Alvarez, S.R. - Source of the conjunctival baclerial flora at birthand implications forophthal- neonatorum prophylaxis. Am. J. Ophthalmol., 106. 458-62,1988.

[11] ¹¹
Isenberg, S.J.; Apt, L.; Yoshinori, R.; Alvarez, S.R. - Bacterial flora of the conjuntiva at birth. J. Pediatr. Ophthalmol. Strabismus., 6: 284, 1986.

[12] ¹²
Jones, D.B. & Robinson, N.M. - Anaerobic ocular infection. Trans. Am. Ophthalmol., 83: 309-29, 1977.

[13] ¹³
Khorazo, D. & Thompson, R. - The bacterial flora of the normal conjunctiva. Arch. Ophthalmol., 18: 1114-6,1935.

[14] ¹⁴
Lawson, A. -The bacteriology of the normal conjuntival sac and its practical bearing on the utility of antiseptics in ophthalmic surgery. Br. Med. J., 2: 486-7, 1898.

[15] ¹⁵
Locather-Khorazo, D. & Gutierrez, E.H. - The bacterial flora of the healthy eye. ln: Locather-Khorazo, D. & Segal, B.C. - Microbiology of the eye. St. Louis, Mosby, 1972, p. 13-23.

[16] ¹⁶
Matuura, H. - Anaerobes in The bacterial flora of The conjunctival sac. Jpn. J. Ophthalmol., 15: 116-24, 1971.

[17] ¹⁷
Molgaard, I-L; Nielsen, P.B.; Kaern, J - A study of The incidence of neonatal conjunctivitis and of its bacterial causes including Chlamydia trachomatis. Acta Ophthal., 62: 461-71, 1984.

[18] ¹⁸
Ostler, H.B.; Okumoto, M. - Anaerobicstreptococcal corneal ulcer. Am. J. Ophthalmol., 81: 379-560, 1976.

[19] ¹⁹
Perkins, R.F.; Kundsin, R.B.; Pratt, M. V.; Abrahamsen, I.; Leibowitz, H.M. - Bacteriology of normal andinfectedconjuntiva.J. Clin. Microbiol., 1: 147-9,1975.

[20] ²⁰
Perry, L.D.; Brinser, I.H.; Kolodner, H. - Anaerobic corneal ulcere. Ophthalmology, 89: 639-42, 1982.

[21] ²¹
Pierce, I.M.; Ward, M.E.; Seal, D.V. - Ophthalmia neonatorum in the 1980s: incidence, etiology and treatment. Br. J. Ophthalmol., 66: 728-31, 1982.

[22] ²²
Prentice, M.J.; Hutchinson, G.R; Taylor-Robinson, D. - Amicrobiological study of neonatal conjunctivae and conjunctivitis. Br. J. Ophthalmol., 61: 601-7,1977.

[23] ²³
Rapoza, P.A.; Quinn, C.T.; Kiessling, L.A.; Taylor, H.R. - Epidemiology of neonatal conjunctivitis. Ophthalmology, 93: 456-61, 1986.

[24] ²⁴
Reeder, J.C.; Westwel, A.I.; Hutchinson, D.N. - Indifferent Streptococci innormal and purulenteyes of neonates. J. Clin. Pathol., 38: 942-5, 1985.

[25] ²⁵
Rosenblatt, J.E. & Stewart, P.R. - Anaerobic bag culturemethod. J. Clin. Microbiol., 1: 527-30,1975.

[26] ²⁶
Rotimi, V.O. & Duerden, B.I. - The development of the bacterial flora in normal neonates. J. Med. Microbiol., 14: 51-62, 1981.

[27] ²⁷
Sandstrom, I. - Etiology and diagnosis of neonatal conjunctivitis. Acta Paediatr. Scand., 76: 221-7.

[28] ²⁸
Sandstrom, K.I.; Beel, T.A.; Chandler, I.W.; Kuo, C.C.; Wang, S-P; Grayston, I.T.; Foy, H.M.; Stamm, W.E.; Cooney, M.K.; Smith, A.L., Holmes, K.K. - Microbial causes of neonatal conjunctivitis. J. Pediatr., 105: 706-10, 1984.

[29] ²⁹
Smith, R.E. - Inflamation after cataract surgery: editorial. Am. J. Ophthalmol., 102: 788-90,1986.

[30] ³⁰
Sutter, V.L.; Citron, D.M.; Finegold, S.M. - Anaerobic bacterology manual. 3.ed. St. Louis, C.V. Mosby Company, 1980. 131p.

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