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Vertical transmission of sexually transmitted infections such as Chlamydia trachomatis and Neisseria gonorrhoeae can cause ophthalmia neonatorum and rarely pulmonary infection.1
To optimise the management of mothers, and their partners, of neonates diagnosed with these infections, we set up a system of direct fax referrals between our Microbiology Department and the local genital-urinary medicine (GUM) clinic. This is in line with the national strategy for sexual health,2 which stresses greater collaboration between agencies. A similar direct referral system is already in place for gynaecology patients diagnosed with sexually transmitted infections.3
We undertook a retrospective case notes review of all neonatal referrals between January 1998 and December 2000. Of 25 neonates referred, 24 had chlamydial and one had gonococcal eye infections.
Five mothers made contact with clinic health advisors and opted for management by their general practitioner. Eleven mothers attended the GUM clinic. No infection was found in three cases that had already received treatment. Genital chlamydia were confirmed in the remaining eight cases. One had co-infection with N gonorrhoeae, which was not suspected in the baby, and another had Trichomonas vaginalis. Contact tracing yielded only eight partners (0.73 per index case). Of these, six attended the same GUM clinic (55% of index cases) and one attended his general practitioner. Four had confirmed chlamydia infection, but no other co-infection was discovered in these men. The remaining nine mothers did not contact the GUM clinic. We ensured that their general practitioners would agree to take over follow up.
There were no complaints from the mothers or their partners about being contacted by the GUM clinic.
The two year review of this initiative shows it to be an effective way of treating and contact tracing mothers of infected neonates. Joint protocols and good communication between all the healthcare professionals are paramount to the success of such a scheme.
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