Safety and effect of chlorhexidine skin cleansing on skin flora of neonates in Bangladesh

Gary L. Darmstadt, M. Monir Hossain, Yoonjoung Choi, Mahfuza Shirin, Luke C Mullany, Maksuda Islam, Samir K. Saha

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Chlorhexidine cleansing of newborn skin is a highly promising intervention for reducing neonatal mortality in developing countries, yet little is known of the mechanism of action. This study examined the impact of a single skin cleansing of hospitalized newborn infants in Bangladesh with baby wipes containing 0.25% chlorhexidine on both qualitative and quantitative skin flora. METHODS: Within 72 hours of birth, the skin of newborns admitted to Dhaka Shishu Hospital was wiped with baby wipes containing 0.25% chlorhexidine (n = 67) or placebo (n = 66) solution. Skin condition was assessed and skin swabs were taken from 3 sites (axillary, peri-umbilical, inguinal) at baseline and 2 hours, 24 hours, 3 days and 7 days after treatment. Skin flora was quantified and colonizing species were identified. FINDINGS: Skin cleansing with chlorhexidine had no adverse effects on skin condition, and resulted in minimal reduction (mean 0.5°C) in body temperature. Positive skin culture rates 2 hours after skin cleansing were approximately 35%-55% lower than the baseline rates for placebo and chlorhexidine groups at all 3 sites. For the chlorhexidine group, positive skin culture rates remained significantly lower than the baseline rates for 24 hours to 3 days, whereas for the placebo group, beyond the first 2-hour follow-up, these values were not lower than baseline in any of the 3 sites. INTERPRETATION: Chlorhexidine skin treatment produced more extended skin cleansing effects than the placebo treatment. It is possible that the quantitative and qualitative reductions observed in the skin flora might contribute to reducing neonatal infections.

Original languageEnglish (US)
Pages (from-to)492-495
Number of pages4
JournalPediatric Infectious Disease Journal
Volume26
Issue number6
DOIs
StatePublished - Jun 2007

Fingerprint

Chlorhexidine
Bangladesh
Newborn Infant
Safety
Skin
Placebos
Umbilicus
Placebo Effect
Groin
Infant Mortality
Body Temperature
Developing Countries

Keywords

  • Chlorhexidine
  • Neonatal sepsis
  • Newborn
  • Skin
  • Skin colonization
  • Skin flora

ASJC Scopus subject areas

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

Cite this

Safety and effect of chlorhexidine skin cleansing on skin flora of neonates in Bangladesh. / Darmstadt, Gary L.; Hossain, M. Monir; Choi, Yoonjoung; Shirin, Mahfuza; Mullany, Luke C; Islam, Maksuda; Saha, Samir K.

In: Pediatric Infectious Disease Journal, Vol. 26, No. 6, 06.2007, p. 492-495.

Research output: Contribution to journalArticle

Darmstadt, Gary L. ; Hossain, M. Monir ; Choi, Yoonjoung ; Shirin, Mahfuza ; Mullany, Luke C ; Islam, Maksuda ; Saha, Samir K. / Safety and effect of chlorhexidine skin cleansing on skin flora of neonates in Bangladesh. In: Pediatric Infectious Disease Journal. 2007 ; Vol. 26, No. 6. pp. 492-495.
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abstract = "BACKGROUND: Chlorhexidine cleansing of newborn skin is a highly promising intervention for reducing neonatal mortality in developing countries, yet little is known of the mechanism of action. This study examined the impact of a single skin cleansing of hospitalized newborn infants in Bangladesh with baby wipes containing 0.25{\%} chlorhexidine on both qualitative and quantitative skin flora. METHODS: Within 72 hours of birth, the skin of newborns admitted to Dhaka Shishu Hospital was wiped with baby wipes containing 0.25{\%} chlorhexidine (n = 67) or placebo (n = 66) solution. Skin condition was assessed and skin swabs were taken from 3 sites (axillary, peri-umbilical, inguinal) at baseline and 2 hours, 24 hours, 3 days and 7 days after treatment. Skin flora was quantified and colonizing species were identified. FINDINGS: Skin cleansing with chlorhexidine had no adverse effects on skin condition, and resulted in minimal reduction (mean 0.5°C) in body temperature. Positive skin culture rates 2 hours after skin cleansing were approximately 35{\%}-55{\%} lower than the baseline rates for placebo and chlorhexidine groups at all 3 sites. For the chlorhexidine group, positive skin culture rates remained significantly lower than the baseline rates for 24 hours to 3 days, whereas for the placebo group, beyond the first 2-hour follow-up, these values were not lower than baseline in any of the 3 sites. INTERPRETATION: Chlorhexidine skin treatment produced more extended skin cleansing effects than the placebo treatment. It is possible that the quantitative and qualitative reductions observed in the skin flora might contribute to reducing neonatal infections.",
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