Omphalitis is an infection of the umbilical stump that typically begins as a superficial skin infection in newborns but can progress to deeper tissue infections or systemic disease. It occurs most commonly in the first two weeks of life, especially in preterm or low birth weight infants. Risk factors include low birth weight, umbilical catheterization, and septic delivery. While clean, dry cord care is usually recommended, topical chlorhexidine has been shown to reduce infections in developing countries. The infection starts from normal bacterial colonization of the umbilical cord that then invades tissues, and can spread beyond the skin to involve muscles or blood vessels.
Omphalitis is an infection of the umbilical stump that typically begins as a superficial skin infection in newborns but can progress to deeper tissue infections or systemic disease. It occurs most commonly in the first two weeks of life, especially in preterm or low birth weight infants. Risk factors include low birth weight, umbilical catheterization, and septic delivery. While clean, dry cord care is usually recommended, topical chlorhexidine has been shown to reduce infections in developing countries. The infection starts from normal bacterial colonization of the umbilical cord that then invades tissues, and can spread beyond the skin to involve muscles or blood vessels.
Omphalitis is an infection of the umbilical stump that typically begins as a superficial skin infection in newborns but can progress to deeper tissue infections or systemic disease. It occurs most commonly in the first two weeks of life, especially in preterm or low birth weight infants. Risk factors include low birth weight, umbilical catheterization, and septic delivery. While clean, dry cord care is usually recommended, topical chlorhexidine has been shown to reduce infections in developing countries. The infection starts from normal bacterial colonization of the umbilical cord that then invades tissues, and can spread beyond the skin to involve muscles or blood vessels.
Omphalitis is an infection of the umbilical stump that typically begins as a superficial skin infection in newborns but can progress to deeper tissue infections or systemic disease. It occurs most commonly in the first two weeks of life, especially in preterm or low birth weight infants. Risk factors include low birth weight, umbilical catheterization, and septic delivery. While clean, dry cord care is usually recommended, topical chlorhexidine has been shown to reduce infections in developing countries. The infection starts from normal bacterial colonization of the umbilical cord that then invades tissues, and can spread beyond the skin to involve muscles or blood vessels.
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Description
Omphalitis, an infection of the umbilical stump, begins in the neonatal period as a
superficial cellulitis but may progress to necrotizing fasciitis, myonecrosis, or systemic disease. Epidemiology Episodes of omphalitis are usually sporadic, but rare epidemics occur. Mean age of onset is 5–9 days in term infants and 3–5 days in preterm infants. Incidence varies from 0.2 to 0.7% of live births in developed countries and up to 21% of live births in developing countries. Risk Factors Low birth weight Prior umbilical catheterization Septic delivery Male sex General Prevention There are multiple methods used for umbilical cord care, many of which are acceptable. Antimicrobial agents applied to the umbilicus may decrease bacterial colonization and prevent omphalitis, particularly in developing countries. Effective methods of umbilical cord care: Clean, dry cord care (AAP/WHO recommended) Triple dye Topical 4% chlorhexidine 70% alcohol solution There is significant evidence to support the use of topical 4% chlorhexidine to prevent omphalitis in developing countries, although it does delay time to cord separation. There is no evidence that application of an antiseptic to the umbilical cord is better than clean, dry cord care in a hospital setting. Pathophysiology Potential bacterial pathogens normally colonize the umbilical stump after birth. These bacteria invade the umbilical stump, leading to omphalitis. Established aerobic bacterial infection, necrotic tissue, and poor blood supply facilitate the growth of anaerobic organisms. Infection may also extend beyond the subcutaneous tissues to involve fascial planes (fasciitis), abdominal wall musculature (myonecrosis), and umbilical and portal veins (phlebitis).
