608. The Effect of Prenatal Screening for Chlamydia trachomatis (CT) on Chlamydial Conjunctivitis in Infants

BACKGROUND: CT was the most common identifiable infectious cause of neonatal conjunctivitis in the USA during the 20th century, accounting for 20–40% of cases. Infection is transmitted to newborns via exposure to infected mothers during passage through the birth canal. The transmission risk for an infant born vaginally to a woman with CT has been reported to be as high as 70%, including newborns with asymptomatic respiratory infection; 8–44% will develop conjunctivitis. The CDC recommended routine screening and treatment of pregnant women for CT infection in the United States in 1993. The aim of this study was to determine the impact of screening and treatment during pregnancy on chlamydial conjunctivitis in infants in our population. METHODS: A retrospective, observational study of all infant eye samples submitted to the Chlamydia Research Laboratory at SUNY Downstate Medical Center for CT culture from 1986 to 2002. Culture results were divided into two groups by time period: pre-screening (1986–1993) and post-screening (1994–2002). RESULTS: A total of 880 samples obtained from infants with signs and symptoms of conjunctivitis were submitted for CT culture, 103 (11.7%) were positive. The number of submitted samples and positive cultures both declined over time. The positivity rate for eye cultures was 15.6% during the pre-screening period (1986–1993) and was 1.8% during post-screening period (1994–2002) (P < 0.0001). A separate hospital audit confirmed >95% of pregnant women were screened during the post-screening period. CONCLUSION: The prevalence of neonatal chlamydial conjunctivitis decreased significantly in our population after the implementation of routine screening and treatment of pregnant women in the United States in 1993.These results also confirm that the most effective way to prevent perinatal chlamydial infection is prenatal screening and treatment of pregnant women. These data have important implications for maternal and infant health globally. DISCLOSURES: All authors: No reported disclosures.