Surface cultures and isolation procedures in infants born under unsterile conditions

Umbilical and axillary skin cultures for bacteria and yeast were obtained within two hours of birth from 108 term infants born vaginally under sterile (52) and nonsterile (56) conditions. The skin of infants born under nonsterile conditions was more frequently colonized (91%) than that of infants born under sterile conditions (66%). The most common skin flora of both groups was Staphylococcus epidermidis, diphtheroids, and Escherichia coli. A significantly higher frequency of colonization with gram-positive cocci and diphtheroids was noted in infants born under nonsterile conditions. Cultures obtained on day 3 or 4 from infants born under sterile conditions revealed a higher frequency of colonization with E coli, enteric organisms, and potential pathogens than cultures obtained immediately after delivery. Cultures did not aid in clinical management, since in this sample no overt infection developed. Culture and isolation procedures in clinically well term infants born under nonsterile conditions are not warranted.