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Gonorrheal ophthalmia neonatorum: Historic impact of Credé’s eye prophylaxis

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Pediatric Infectious Diseases Revisited

Part of the book series: Birkhäuser Advances in Infectious Diseases ((BAID))

Abstract

In the pre-antibiotic era gonorrhea showed a high prevalence also in industrialized countries. In Germany, more than 10% of all newborns developed gonorrheal ophthalmia neonatorum. Clinical courses of gonorrheal ophthalmia neonatorum were quite different in their severity but often caused significant impairment of eyesight up to total blindness in more than 5%. This accounted for 25–40% of cases of blindness in Germany. It was Carl Siegmund Franz Credé (1819–1892), a German obstetrician, who introduced the eye prophylaxis of eye drops containing 2% silver nitrate solution to every newborn child in his clinic in Leipzig on June 1st 1880. The incidence of gonorrheal ophthalmia neonatorum immediately decreased from 10% to 0%. Credé actively communicated these results and immediately published them in four publications within a time period of 3 years. These publications, which are discussed here, are written in a very pragmatic and strictly clinical style, ignoring new basic scientific insights into the microbiology of gonorrhea and the discovery of the corresponding pathogen, the “Micrococcus” by Albert Neisser, which Credé considered unimportant for his purposes. Against a high degree of opposition by many physicians, Credé put all enthusiasm into the call for education of midwives in this technique. Credé knew that this was the central way to ensure that all newborns could obtain this prophylaxis, including outpatients and home deliveries. Credé’s eloquence led to the rapid spreading of “his” eye prophylaxis over the rest of the world. The concentration of silver nitrate was often reduced from 2% to 1% thereafter and in most countries the performance of this prophylaxis was rapidly enforced by law. By introducing this method, Credé saved or improved the eyesight of millions of people — a significant contribution to obstetrics, neonatology and pediatrics, ophthalmology and mankind. Still today, in the antibiotic era, other topical regimens for antiseptic prophylaxis against ophthalmia neonatorum are often referred to as “Credé’s prophylaxis”.

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References

  1. Feng QL, Wu J, Chen GQ, Cui FZ, Kim TN, Kim JO (2000) A mechanistic study of the antibacterial effect of silver ions on Escherichia coli and Staphylococcus aureus. J Biomed Mater Res 52: 662–668

    Article  PubMed  CAS  Google Scholar 

  2. Quelmaltz ST (1740) De caecitate infantum floris albi materni ejusque virulanti pedisseque dissertatione. PhD Thesis, Leipzig

    Google Scholar 

  3. Gibson B (1807) On the common cause of puriform ophthalmia of new-born children. Edinburgh Med Surg J 3: 159–161

    Google Scholar 

  4. Ammon FA v (1825) Pathology of the eye bulbus and its adnexes during the illness entitled ophthalmitis of the new-born child (“Das pathologische Verhalten des Augapfels und seiner Häute während des Verlaufs der sogenannten Augenentzündung neugeborener Kinder”). In: Hecker’s Annalen, Vol 1, TCF Enslin, Berlin, 129–142

    Google Scholar 

  5. Bednar A (1848) Treatment of ophthalmia neonatorum (“Über die Behandlung der Augenentzündung der Neugeborenen”). Zschr k k Ges Ärzte 5: 139–145

    Google Scholar 

  6. Mackenzie W (1854) Practical Treatise on the Diseases of the Eye. Longmann, London

    Google Scholar 

  7. Noeggerath E (1872) Die latente Gonorrhoe im Weib (Latent Female Gonorrhea). Seiler, Bonn

    Google Scholar 

  8. Oriel JD (1991) Eminent venerologists 5: Carl Credé. Genitourin Med 67: 67–69

    PubMed  CAS  Google Scholar 

  9. Kibel MA (1981) Silver nitrate and the eyes of the newborn — a centennial. S Afr Med J 60: 979–980

    PubMed  CAS  Google Scholar 

  10. Novak JM (1984) Current status of Credé prophylaxis. Am J Optometry Physiol Optics 61: 340–346

    CAS  Google Scholar 

  11. Schaller UC, Klauss V (2001) Is Credé’s prophylaxis for ophthalmia neonatorum still valid? Bull WHO 79: 262–263

    PubMed  CAS  Google Scholar 

  12. Dunn PM (2000) Dr. Carl Credé (1819–1892) and the prevention of ophthalmia neonatorum. Arch Dis Child Fetal Neonatal Ed 83: 158–159

    Article  Google Scholar 

  13. Rosenberg J (1892) In memoriam, Carl Siegmund Franz Credé. Am J Obstet Gynecol 25: 780–783

    Google Scholar 

  14. Leopold G (1891) Talk in remembrance of Carl Siegmund Franz Credé (“Carl Siegmund Franz Credé. Gedächtnisrede”). Arch Gynäkol 42: 193–212

    Article  Google Scholar 

  15. Author unknown (Dr. L) (1892) Karl Credé. Illustrierte Zeitung, press release, no 2543

    Google Scholar 

  16. Credé CSF (1854) Manual expression of the placenta (“Handgriff zur Entfernung der Plazenta”). Klinische Vorträge über Geburtshilfe, Hirschwald, Berlin, 599–600

    Google Scholar 

  17. Speer H (1957) Carl Siegmund Credé, placental expression, and the prevention of ophthalmia neonatorum. Obstet Gynecol 10: 335–339

    Google Scholar 

  18. Credé CSF (1884) Incubation systems for early for date and weak small children (“Ueber Erwärmungsgeräthe für frühgeborene und schwächliche kleine Kinder”). Arch Gynäkol 24: 128–147

    Article  Google Scholar 

  19. Credé CSF (1881) Die Verhütung der Augenentzündung der Neugeborenen (“Prevention of inflammatory eye disease in the newborn”). Arch Gynäkol 17: 50–53

    Article  Google Scholar 

  20. Credé CSF (1881) Die Verhütung der Augenentzündung der Neugeborenen (“Prevention of inflammatory eye disease in the newborn”). Arch Gynäkol 18: 367–370

    Article  Google Scholar 

  21. Credé CSF (1883) Die Verhütung der Augenentzündung der Neugeborenen (“Prevention of inflammatory eye disease in the newborn”). Arch Gynäkol 21: 179–195

    Article  Google Scholar 

  22. Credé CSF (2001) Prevention of inflammatory eye disease in the new-born (“Die Verhütung der Augenentzündung der Neugeborenen”). Translation of [19] by WHO. Bull WHO 79: 265–266

    Google Scholar 

  23. Credé CSF (1884) Die Verhütung der Augenentzündung der Neugeborenen (“Prevention of Inflammatory Eye Disease in the Newborn”). Hirschwald, Berlin

    Google Scholar 

  24. Hecker C v (1882) On blephanorrhoea neonatorum (“Über Blephanorrhoea neonatorum”). Arch Gynäkol 20: 386–398

    Article  Google Scholar 

  25. Oriel JD (1989) Eminent venerologists. 1. Albert Neisser. Genitourin Med 65: 229–234

    PubMed  CAS  Google Scholar 

  26. Scholz A, Wasik F (1985) Albert Neisser. Int J Dermatol 24: 373–377

    PubMed  CAS  Google Scholar 

  27. http://www.onmeda.de/lexika/persoenlichkeiten/neisser/html

    Google Scholar 

  28. http://www.klinikum.uni-heidelberg.de/index.php?id=4114%20-%2017k

    Google Scholar 

  29. http://www.lexikon.donx.de/?action=detail­ow=Albert%20Neisserάrk=Neisser

    Google Scholar 

  30. http://www.whonamedit.com/doctor.cfm/2441.html

    Google Scholar 

  31. Kampmeier RH (1978) Identification of the gonococcus by Albert Neisser. 1879. Sex Trans Dis 5: 71–72

    Article  CAS  Google Scholar 

  32. Haneveld GT (1979) The centenary of the gonococcus: the importance of its discovery and the acknowledgement of this in The Netherlands (Ludwig Sigesmund Albert Neisser). Ned Tijdschr Geneeskd 123: 1875–1878

    PubMed  CAS  Google Scholar 

  33. Neisser A (1879) A form of micrococcus typical for gonorrhea (“Über eine der Gonorrhoe eigenthümliche Micrococcenform”). Zentralbl Med Wissenschaften 17: 497–500

    Google Scholar 

  34. Neisser A (1882) Micrococci and gonorrhea (“Die Mikrokokken der Gonorrhoe”). Dtsch Med Wochenschr 8: 279–283

    Article  Google Scholar 

  35. Köhler W (1994) Historical development of medical microbiology (“Historische Entwicklung der Medizinischen Mikrobiologie”). In: H Brandis, HJ Eggers, W Köhler, G Pulverer (eds): Handbook of Medical Microbiology (“Lehrbuch der Medizinischen Mikrobiologie”). Fischer, Stuttgart, 3–17

    Google Scholar 

  36. Credé C, Winckel F (1875) Handbook for Midwives (“Lehrbuch der Hebammenkunst”). S. Hirzel, Leipzig, 117–118 / 237–243 (§§167, 358–3

    Google Scholar 

  37. Credé C, Leopold G (1892) Handbook of Obstetrics for Midwives (“Lehrbuch der Geburtshülfe für Hebammen”). S. Hirzel, Leipzig, 254–58 (§§ 358–3

    Google Scholar 

  38. Vail D (1963) Lucien Howe: the laboratory and experimental ophthalmology. Am J Ophthalmol 55: 261–279

    PubMed  CAS  Google Scholar 

  39. Sullivan MF (1952) Silver acetate as a prophylactic for ophthalmia neonatorum. J Indian Med Assoc 21: 528–529

    Google Scholar 

  40. Cordell JPM (1936) Ophthalmia neonatorum. Trans Ophthalmol Soc UK 56: 3–7

    Google Scholar 

  41. Holmes KK, Counts GW, Beatty HN (1971) Disseminated gonococcal infection. Ann Intern Med 74: 979–993

    PubMed  CAS  Google Scholar 

  42. Wilcox RR (1972) A world look at the venereal disease: recrudescence of the venereal diseases. Med Clin North Am 56: 1057–1071

    Google Scholar 

  43. Armstrong JH, Zacarias F, Rein MF (1976) Ophthalmia neonatorum: a chart review. Pediatrics 57: 884–892

    PubMed  CAS  Google Scholar 

  44. Handsfield HH, Hodson KK (1973) Neonatal gonococcal infection: orogastric contamination with Neisseria gonorrhoeae. J Am Med Assoc 225: 697–701

    Article  CAS  Google Scholar 

  45. Huber-Spitzy V, Arocker W, Schmidt C (1987) Ophthalmia neonatorum. Klin Mbl Augenheilk 191: 341–343

    PubMed  CAS  Google Scholar 

  46. Lehrfeld L (1935) Limitations of use of silver nitrate in prevention of ophthalmia neonatorum. J Am Med Assoc 104: 1468–1469

    Google Scholar 

  47. Robson KS (1967) The role of the eye-to-eye contact in maternal-infant attachment. J Child Psychol Psychiatry 8: 13–25

    Article  PubMed  CAS  Google Scholar 

  48. Nishida H, Risemberg HM (1975) Silver nitrate ophthalmic solution and chemical conjunctivitis. Pediatrics 56: 368–373

    PubMed  CAS  Google Scholar 

  49. Butterfield PM, Emde RN, Svejda MJ (1981) Does the early application of silver nitrate impair maternal attachment? Pediatrics 67: 737–738

    PubMed  CAS  Google Scholar 

  50. Graf H, Retzke U, Schilling C, Schmidt M (1994) Reaction of the ophthalmic front region to the Credé-prophylaxis (“Die Reaktion des vorderen Augenabschnittes auf die Credé-Prophylaxe”). Zentralbl Gynäkol 116: 639–642

    PubMed  CAS  Google Scholar 

  51. Greenberg M, Vandow JE (1961) Ophthalmia neonatorum: evaluation of different methods of prophylaxis in New York City. Am J Public Health 51: 836–845

    Article  CAS  Google Scholar 

  52. CDC (Centers for Disease Control) (1989) Sexually transmitted diseases treatment guidelines. MMWR 38: 8

    Google Scholar 

  53. Chen JY (1992) Prophylaxis of ophthalmia neonatorum: comparison of silver nitrate, tetracycline, erythromycin and no prophylaxis. Pediatr Infect Dis J 11: 1026–1030

    PubMed  CAS  Google Scholar 

  54. Seiga K, Shoji T (1993) Chemoprophylaxis of ophthalmia neonatorum through vertical infection. Evaluation of Crede’s method using norfloxacin and gentamycin. Jpn J Antibiot 46: 331–336

    PubMed  CAS  Google Scholar 

  55. Kramer A, Behrens-Baumann W (1997) Prophylactic use of topical anti-infectives in ophthalmology. Ophthalmologica 211(S1): 68–76

    Article  PubMed  CAS  Google Scholar 

  56. Benevento WJ, Murray P, Reed CA, Pepose JS (1990) The sensitivity of Neisseria gonorrhoeae, Chlamydia trachomatis, and herpes simplex type II to disinfection with povidone-iodine. Am J Ophthalmol 109: 329–333

    PubMed  CAS  Google Scholar 

  57. Isenberg SJ, Apt L, Yoshimori R, Leake RD, Rich R (1994) Povidone-iodine for ophthalmia neonatorum prophylaxis. Am J Ophthalmol 118: 701–706

    PubMed  CAS  Google Scholar 

  58. Isenberg SJ, Apt L, Wood M (1995) A controlled trial of povidone-iodine as prophylaxis against ophthalmia neonatorum. N Engl J Med 332: 562–566

    Article  PubMed  CAS  Google Scholar 

  59. Reimer K, Fleischer W, Brogmann B, Schreier H, Burkhard P, Lanzendorfer A, Gumbel H, Hoekstra H, Behrens-Baumann W (1997) Povidone-iodine liposomes — an overview. Dermatology 195(S2): 93–99

    Article  PubMed  Google Scholar 

  60. Kramer A, Below H, Behrens-Baumann W, Muller G, Rudolph P, Reimer K (2002) New aspects of the tolerance of povidone-iodine in different ex vivo models. Dermatology 204(S1): 86–91

    Article  PubMed  CAS  Google Scholar 

  61. Isenberg SJ, Apt L, Campeas D (2002) Ocular applications of povidone-iodine. Dermatology 204(S1): 92–95

    Article  PubMed  CAS  Google Scholar 

  62. Simon JW (2003) Povidone-iodine prophylaxis of ophthalmia neonatorum. Br J Ophthalmol 87: 1437

    Article  PubMed  CAS  Google Scholar 

  63. Isenberg SJ, Apt L, Del Signore M, Gichuhi S, Bermann NG (2003) A double application approach to ophthalmia neonatorum prophylaxis. Br J Ophthalmol 87: 1449–1452

    Article  PubMed  CAS  Google Scholar 

  64. The Editorial Board (1980) Centenary of Credé prophylaxis. Am J Ophthalmol 90: 874–875

    Google Scholar 

  65. Tietze KW (1994) Credé’s prophylaxis. Report of a commission of the German Authority of Health (“Die Credé Prophylaxe. Bericht einer Kommission des Bundesgesundheitsamtes”). Ophthalmologe 91: 551–552

    PubMed  CAS  Google Scholar 

  66. Watten RG (1994) Reinvention of visual fatigue: accumulation of scientific knowledge or neglect of scientific history? Ophthalmic Physiol Opt 14: 428–432

    Article  PubMed  CAS  Google Scholar 

  67. Editorial Board (2002) New aspects in prophylaxis of ophthalmia neonatorum (Credé prophylaxis). Wien Klin Wochenschr 114: 171–172

    Google Scholar 

  68. Laga M, Meheus A, Piot P (1989) Epidemiology and control of gonococcal ophthalmia neonatorum. Bull WHO 67:471–477 [Erratum: Bull WHO (1990) 68: 690]

    PubMed  CAS  Google Scholar 

  69. Gilbert C, Foster A (2001) Childhood blindness in the context of VISION 2020 — The Right to Sight. Bull WHO 79: 227–232; http://www.scielosp.org/scielo.php?pid=S004296862000100300011&script=sci_arttext&tlng=en

    PubMed  CAS  Google Scholar 

  70. http://www.matrikel.unizh.ch/pages/45.htm

    Google Scholar 

  71. http://www.internet-taubenschlag.de/medizin/bericht7

    Google Scholar 

  72. http://www.uni-kiel.de/anorg/lagaly/group/klausSchiver/Lottermoser.pdf

    Google Scholar 

  73. Hille M (1897) On Dr. Credé’s Antiseptics: Silver and Silver-Salts and their Usage within Dental Medicine (“Ueber Dr. Credé’s neue Antiseptica: Silber und Silbersalze und deren Anwendung in der Zahnheilkunde”). “Separatabdruck” (Reprint) from Deutsche Monatsschrift für Zahnheilkunde 15(5). A. Pries, Leipzig, 1–9

    Google Scholar 

  74. Beyer JL (1904) Use of Kolloidal Metalls in Medicine: Silver and Mercury (“Über die Verwendung kolloider Metalle — Silber und Quecksilber — in der Medizin”). L. Simion, Berlin, Germany

    Google Scholar 

  75. http://www.whonamedit.com/doctor.cfm/2028.html

    Google Scholar 

  76. Albrecht B, Albrecht G (1989) Carl Credé, 1878–1952, an unjustifiedly accused physician (“Carl Credé, 1878–1952, als Arzt unschuldig verurteilt”). In: B Albrecht, G Albrecht (eds): Diagnoses. Remembrances on Physician of the 20th Century (“Diagnosen. Ärzteerinnerungen aus dem 20. Jahrhundert”). Der Morgen, Berlin, 294–307

    Google Scholar 

  77. Albrecht B, Albrecht G (1989) Carl Credé. In: Albrecht B, Albrecht G (eds): Diagnoses. Remembrances on physician of the 20th century (“Diagnosen. Ärzteerinnerungen aus dem 20. Jahrhundert”). Der Morgen, Berlin, 416–417

    Google Scholar 

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  1. Axel Schmidt, Institute of Microbiology and Virology, Faculty of Medicine, University Witten/Herdecke, Stockumer Str. 10, 58448, Witten, Germany

    Axel Schmidt

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  1. Pediatric Infectious Diseases Department of General Pediatrics, University Children’s Hospital, Moorenstr. 5, 40225, Düsseldorf, Germany

    Horst Schroten

  2. Children’s Hospital HELIOS Klinikum, Witten-Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany

    Stefan Wirth

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Schmidt, A. (2007). Gonorrheal ophthalmia neonatorum: Historic impact of Credé’s eye prophylaxis. In: Schroten, H., Wirth, S. (eds) Pediatric Infectious Diseases Revisited. Birkhäuser Advances in Infectious Diseases. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8099-1_4

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