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Umbilical microflora and pediatric surgery.

Keiichiro Tanaka1, Takafumi Mikami2, Yu Ebata2

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This summary is machine-generated.

The umbilicus is a common entry point for bacteria in pediatric surgery. This study found specific bacterial profiles and high cefazolin resistance in children

Keywords:
Laparoscopic surgeryMRSAPediatric surgerySurgical site infectionUmbilical microflora

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Area of Science:

  • Pediatric Surgery
  • Microbiology
  • Infectious Disease

Background:

  • The umbilicus is a frequent entry point for peritoneal infections in pediatric surgery due to its humid environment promoting bacterial colonization.
  • Umbilical microflora in children remains underreported, necessitating characterization for surgical site infection (SSI) prevention.

Purpose of the Study:

  • To characterize the umbilical microflora in children prior to antiseptic skin preparation.
  • To identify potential risk factors and guide antibiotic selection for pediatric surgical procedures involving umbilical access.

Main Methods:

  • Prospective review of 123 children (≤15 years) undergoing umbilical access surgery.
  • Collection of umbilical swabs for microbial culture before antiseptic skin preparation.
  • Analysis of microflora, patient demographics, and clinical outcomes, including SSI.

Main Results:

  • Coagulase-negative Staphylococcus and Corynebacterium were the most common bacteria found.
  • Increased isolation of intestinal bacteria was observed in children aged ≤3 years (P=0.03).
  • High cefazolin (CEZ) resistance (46.1%) was detected in umbilical bacteria; no SSIs occurred.

Conclusions:

  • This is the first study to report umbilical microflora in over 100 children, revealing similarities to adult flora except in those ≤3 years.
  • Antibiotic selection for children ≤3 years should consider CEZ resistance and the presence of intestinal bacteria.
  • Umbilical microflora data can inform antibiotic choice for SSI treatment, and pre-operative cultures are recommended for high-risk pediatric patients.