신생아 정상결막낭의 균총(菌叢)에 관한 연구

Abstract

[한글]

Studies on Microbial Flora of the Conjunctival Sac in New-born Infants

Young Jae Hong

Department of Medical Science, The Graduate School, Yonser University

(Directed by Prof. Soon Kak Hong)

Eyes, one of the exposed organs of human body, are prone to be contaminated with

vaginal flora during birth (Grunberger and Kofler, 1954) and later in life a normal

flora of the eye will be established through contamination from the environments.

In this regard, studies have been made on the normal bacterial and fungal flora

of conjunctival sac and eye lids in an effort to identify the causative agents of

ocular infections.

Grunberger and Kofler(1954)carried out a simultaneous study of the vaginal flora

of the mother and the eye flora of the new-born infant. In his study,

Staphylococcus epidermidis, Staphylococcus arueus, streptococci, and sometimes

E.coli were transmited to the infant's eyes during birth. The authors pointed out

the failure of silver nitrate to influence parasitism, particularly by S.aureus.

In the study of Hammeke and Ellis(1960) of 52 new-born infants, only I was

positrve for fungus in the conjunctival sac.

In Korea, studies have been made on the normal flora of child and adult

conjunctival sacs and new-born infant's eye lids(Lee, 1964; Kim, 1965; Kim, 1973).

In order to provide basic informations on the causative organisms of ocular

infection in infants, studies were made on microbial flora of new-born conjunctival

sac among Koreans, not previously reported in this nation.

Materials and Methods

A. The sources of culture specimens

In the delivery room at Severance Hospital 185 culture specimens were collected

from 93 babies who were spontaneously delivered through the vagina(NSVD new-born

infants)and in the operating room 34 culture specimens from 17 babies who were

delivered with Cesarean section(C/S new-born infants)during 4 months period from

July to Oct, 1973.

B. Method

1.Collection of the specimens

Culture specimens were obtained at birth and 2 days later(after silver nitrate

instillation) with a sterile cotton swab by a single gentle transverse swabbing of

the exposed lower conjunctival sornis.

2. Isolation and identification of the bacteria

The collected specimens were streaked on blood agar plates and incubated

aerobically at 37℃, for 24 to 48 hours. The identification of the isolates on

blood agar plates was made with colony morphology, Gram staining, and selected

appropriate tests for each organisms from Bergey's manual(Breed et al., 1957).

3. Isolation and identification of the fungi.

The conjunctival swab was streaked on a Sabour명 glucose agar plate containing

chloramphenicol(100mg/L) and incubated at 25℃, from 1 to 4 weeks, followed by

slide culture for microscopic observation. The identification of the fungi isolated

was made by the procedure of Thom and Raper(1945), Raper and Thom(1949), Lodder and

Kreger-van Rij(1952), Barnett(1958), and Raper and Fennell(1965).

Conclusion

In order to establish the normal flora of the conjunctival sac among new-born

Korean infants, isolation and identification of bacteria and fungi was conducted

with 1185 culture specimens(NSVD new-born infants) and culture specimens(C/S

new-born infants) obtained during the period from July to Oct. 1973. The results

are summarized as follows:

1. Of 185 culture specimens(NSVD new-born imnfants) collected, 17 specimens(9.2%)

at birth and 99 specimens(53.5%) 2 day later yielded bacterial growth, and 8

specimens(4.3%) at birth and 7 specimens(3.7%) 2 days later provided fungal growth.

2. Among the specimens(NSVD new-born infants) yielding positive growth, growth of

a single species of either bacteria or fungi was obtained from 21 specimens(11.3%)

at birth and 80 specimens(43.3%)2 days later. Growth of 2 species was obtained from

4 specimens(2.2%) at birth and 13 specimens(7.0%)2 days later. No specimen showed

the growth of 3 or more species.

3. Among the incidences of isolation of bacterial species(NSVD new-born infants),

S.aureus(2.8%)was the one with the highest frequency of isolation at birth and was

followed by S.epidermidis(2.2%)and Streptococcus viridans(1.6%). At two days later,

S. Epidermidis(23.5%), S.aureous(21.9%)and Diphtheroid(2.8%)were found in order of

lower frequencies.

4. Among the incidences of isolation of fungal species(NSVD new-born infants),

Candida albicans(3.3%) was the one with the highest frequency of isolation and was

followed by Penicillium sp.(0.5%) and Cladosporium sp.(0.5%) at birth. At two days

later, Aspergillus sp.(0.5%) and Cephalothecium sp.(0.5%) were found in order of

lower frequencies.

5. Of 34 culture specimens(C/S new-born infants)collected, there was no growth of

bacteria and fungi at birth, but 20(5.8%)provided fungal trowth 2 days later.

6. Among the incidences of isolation of bacterial species(C/S nes-born infants) 2

days later, S.epidermidis(26.5%) was the one with the highest frequency of

isolation and was followed by S.aureus(23.5%), Gram-negative bacillus(5.9%) and

Streptococcus viridans(2.9%)in order, and only 2 species of fungi(Cephalothecium

sp. 0.5% and Hormodendrum sp. 0.5%)were isolated.

7. There was little difference in the incidences of isolation of bacteria and

fungi between the culture specimens of NSVD(2 days after silver nitrate treated)

and C/S(2 days after silver nitrate non-treated) new-born infants.

[영문]

Eyes, one of the exposed organs of human body, are prone to be contaminated with vaginal flora during birth (Grunberger and Kofler, 1954) and later in life a normal flora of the eye will be established through contamination from the environments.

In this regard, studies have been made on the normal bacterial and fungal flora of conjunctival sac and eye lids in an effort to identify the causative agents of ocular infections.

Grunberger and Kofler(1954)carried out a simultaneous study of the vaginal flora of the mother and the eye flora of the new-born infant. In his study, Staphylococcus epidermidis, Staphylococcus arueus, streptococci, and sometimes E.coli were transmited to the infant's eyes during birth. The authors pointed out the failure of silver nitrate to influence parasitism, particularly by S.aureus.

In the study of Hammeke and Ellis(1960) of 52 new-born infants, only I was positrve for fungus in the conjunctival sac.

In Korea, studies have been made on the normal flora of child and adult conjunctival sacs and new-born infant's eye lids(Lee, 1964; Kim, 1965; Kim, 1973).

In order to provide basic informations on the causative organisms of ocular infection in infants, studies were made on microbial flora of new-born conjunctival sac among Koreans, not previously reported in this nation.

Materials and Methods

A. The sources of culture specimens

In the delivery room at Severance Hospital 185 culture specimens were collected from 93 babies who were spontaneously delivered through the vagina(NSVD new-born infants)and in the operating room 34 culture specimens from 17 babies who were

delivered with Cesarean section(C/S new-born infants)during 4 months period from July to Oct, 1973.

B. Method

1.Collection of the specimens

Culture specimens were obtained at birth and 2 days later(after silver nitrate instillation) with a sterile cotton swab by a single gentle transverse swabbing of the exposed lower conjunctival sornis.

2. Isolation and identification of the bacteria

The collected specimens were streaked on blood agar plates and incubated aerobically at 37℃, for 24 to 48 hours. The identification of the isolates on blood agar plates was made with colony morphology, Gram staining, and selected appropriate tests for each organisms from Bergey's manual(Breed et al., 1957).

3. Isolation and identification of the fungi.

The conjunctival swab was streaked on a Sabour명 glucose agar plate containing chloramphenicol(100mg/L) and incubated at 25℃, from 1 to 4 weeks, followed by slide culture for microscopic observation. The identification of the fungi isolated was made by the procedure of Thom and Raper(1945), Raper and Thom(1949), Lodder and Kreger-van Rij(1952), Barnett(1958), and Raper and Fennell(1965).

Conclusion

In order to establish the normal flora of the conjunctival sac among new-born Korean infants, isolation and identification of bacteria and fungi was conducted with 1185 culture specimens(NSVD new-born infants) and culture specimens(C/S new-born infants) obtained during the period from July to Oct. 1973. The results

are summarized as follows:

1. Of 185 culture specimens(NSVD new-born imnfants) collected, 17 specimens(9.2%) at birth and 99 specimens(53.5%) 2 day later yielded bacterial growth, and 8 specimens(4.3%) at birth and 7 specimens(3.7%) 2 days later provided fungal growth.

2. Among the specimens(NSVD new-born infants) yielding positive growth, growth of a single species of either bacteria or fungi was obtained from 21 specimens(11.3%) at birth and 80 specimens(43.3%)2 days later. Growth of 2 species was obtained from 4 specimens(2.2%) at birth and 13 specimens(7.0%)2 days later. No specimen showed the growth of 3 or more species.

3. Among the incidences of isolation of bacterial species(NSVD new-born infants), S.aureus(2.8%)was the one with the highest frequency of isolation at birth and was followed by S.epidermidis(2.2%)and Streptococcus viridans(1.6%). At two days later, S. Epidermidis(23.5%), S.aureous(21.9%)and Diphtheroid(2.8%)were found in order of lower frequencies.

4. Among the incidences of isolation of fungal species(NSVD new-born infants), Candida albicans(3.3%) was the one with the highest frequency of isolation and was followed by Penicillium sp.(0.5%) and Cladosporium sp.(0.5%) at birth. At two days

later, Aspergillus sp.(0.5%) and Cephalothecium sp.(0.5%) were found in order of lower frequencies.

5. Of 34 culture specimens(C/S new-born infants)collected, there was no growth of bacteria and fungi at birth, but 20(5.8%)provided fungal trowth 2 days later.

6. Among the incidences of isolation of bacterial species(C/S nes-born infants) 2 days later, S.epidermidis(26.5%) was the one with the highest frequency of isolation and was followed by S.aureus(23.5%), Gram-negative bacillus(5.9%) and Streptococcus viridans(2.9%)in order, and only 2 species of fungi(Cephalothecium sp. 0.5% and Hormodendrum sp. 0.5%)were isolated.

7. There was little difference in the incidences of isolation of bacteria and fungi between the culture specimens of NSVD(2 days after silver nitrate treated) and C/S(2 days after silver nitrate non-treated) new-born infants.