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Prevention and control of neonatal pyoderma with chlorhexidine
Acta Paediatrica Scandinavica
|July 1, 1984
Summary
Routine cord care with 4% chlorhexidine effectively prevented staphylococcal pyoderma and omphalitis in newborns. This method significantly reduced nursery colonization and post-discharge infections, outperforming ethanol.
Area of Science:
- Neonatal care
- Infectious disease control
- Public health microbiology
Background:
- Neonatal infections, particularly those caused by Staphylococcus aureus and streptococci, pose a significant risk to infants.
- Pyoderma and omphalitis are common neonatal skin infections that can lead to severe complications.
- Current neonatal cord care practices require evaluation for efficacy in preventing bacterial colonization and infection.
Purpose of the Study:
- To assess the effectiveness of routine cord care using a 4% chlorhexidine detergent solution in preventing staphylococcal colonization and neonatal pyoderma.
- To compare the efficacy of chlorhexidine cord care with 70% ethanol in preventing omphalitis.
- To investigate the source of post-discharge staphylococcal infections.
Main Methods:
- A study involving 5,220 infants in two Swedish hospitals from 1979-1982.
- Implementation of 4% chlorhexidine detergent solution for routine cord care in one hospital.
- Use of quantitative sampling and phage-typing to track Staph. aureus strains.
- Comparison of infection rates between chlorhexidine and 70% ethanol cord care.
Main Results:
- Nursery colonization with Staph. aureus and streptococci significantly decreased with chlorhexidine care.
- Chlorhexidine cord care proved clinically efficient in preventing nursery pyoderma and controlling post-discharge staphylococcal infections.
- Most post-discharge lesions were traced back to nursery-derived infections.
- Ethanol cord care failed to prevent omphalitis, while chlorhexidine reduced incidence from 21% to 1%.
Conclusions:
- Routine cord care with 4% chlorhexidine is a highly effective method for preventing neonatal pyoderma and staphylococcal infections.
- Chlorhexidine cord care significantly reduces nursery colonization and subsequent infections, including omphalitis.
- The study highlights the superiority of chlorhexidine over ethanol for neonatal cord care in preventing bacterial infections.