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Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression

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Omphalitis and Concurrent Serious Bacterial Infection.

Ron L Kaplan¹, Andrea T Cruz², Stephen B Freedman³

¹Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington.

|April 20, 2022

Summary

This summary is machine-generated.

Omphalitis in infants is typically mild. Serious bacterial infections and adverse outcomes are rare, suggesting routine testing may be unnecessary for well-appearing, afebrile infants.

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Area of Science:

Pediatrics
Infectious Diseases
Neonatal Care

Background:

Omphalitis, an infection of the umbilical stump, can be a concern in infants.
Prompt diagnosis and management are crucial to prevent serious complications.

Purpose of the Study:

To describe the clinical presentation of omphalitis in infants.
To determine the prevalence of concurrent serious bacterial infections (SBI) in these infants.
To evaluate outcomes associated with omphalitis.

Main Methods:

A multicenter retrospective cohort study involving 28 sites.
Reviewed records of 566 infants aged ≤90 days with omphalitis from January 2008 to December 2017.
Collected data on demographics, clinical presentation, laboratory results, treatments, and outcomes.

Main Results:

Most infants (95%) appeared well; 11% had fever and 25% had feeding issues.
Pathogen detection rates were low in blood (1.1%), urine (0.9%), and cerebrospinal fluid (0.9%) cultures.
Local infections commonly involved Staphylococcus aureus (methicillin-sensitive and resistant) and E. coli. Serious complications like sepsis or shock occurred in 2.1% of infants, primarily those younger than 28 days.

Conclusions:

Omphalitis in infants typically presents as mild, localized disease.
Serious bacterial infections and adverse outcomes are uncommon in infants with omphalitis.
Routine testing for SBI may not be necessary for afebrile, well-appearing infants with omphalitis, especially older infants.