Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: A review of the evidence

Luke C Mullany, Gary L. Darmstadt, James M. Tielsch

Research output: Contribution to journalArticle

Abstract

In developing countries umbilical cord infections constitute a major cause of neonatal morbidity and pose significant risk for mortality, whereas outbreaks of cord infections continue to occur in developed country nurseries. Cord infections in developing countries can be prevented through increasing access to tetanus toxoid immunization during pregnancy, promoting clean cord care and reducing harmful cord applications and behaviors. Interventions introduced in both developed and developing countries to reduce exposure of the cord to infectious pathogens include clean cord cutting, hand-washing before and after handling the baby, bathing of the infant with antimicrobial agents and application of antimicrobials to the cord. Despite the importance of umbilical cord care, both traditionally and medically, there have been few randomized trials investigating the impact of different cord care regimens on rates of local or systemic infections, particularly in developing countries. This review examines available data on umbilical cord care, with a particular focus on those comparing rates of bacterial colonization and/or rates of cord infection among neonates receiving different umbilical cord care regimens. Although most investigators agree that topical antimicrobials reduce bacterial colonization of the cord, a firm relationship between colonization and infection has not been established. Further research in developed countries, including follow-up beyond hospital discharge, is required before advising on "best cord care practices." The paucity of published reports from developing countries indicates the need to investigate the impact of antimicrobial applications on cord and systemic infections in a community-based, prospective manner.

Original languageEnglish (US)
Pages (from-to)996-1002
Number of pages7
JournalPediatric Infectious Disease Journal
Volume22
Issue number11
DOIs
StatePublished - Nov 2003

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Umbilical Cord
Bacterial Infections
Newborn Infant
Developing Countries
Infection
Developed Countries
Hand Disinfection
Tetanus Toxoid
Nurseries
Anti-Infective Agents
Disease Outbreaks
Immunization
Research Personnel
Morbidity
Pregnancy
Mortality
Research

Keywords

  • Antimicrobials
  • Bacterial infections
  • Colonization
  • Neonatal mortality
  • Neonatal sepsis
  • Omphalitis
  • Tetanus
  • Umbilical cord care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection : A review of the evidence. / Mullany, Luke C; Darmstadt, Gary L.; Tielsch, James M.

In: Pediatric Infectious Disease Journal, Vol. 22, No. 11, 11.2003, p. 996-1002.

Research output: Contribution to journalArticle

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