Neonatal bacterial infections in developing countries: strategies for prevention

Topically Applied Sunflower Seed Oil Prevents Invasive Bacterial Infections in Preterm Infants in Egypt

“…Another report suggested that topical applications of Aquaphor might serve as a source for nosocomial infections with coagulase-negative staphylococci and Gram-negative organisms, 41 and a recently completed multicenter U.S.-based trial showed that Aquaphor therapy increased relative risk (odds ratio, 1.43) for sepsis with coagulase-negative staphylococci among neonates weighing 501-749 g; no effects were seen in neonates weighing 750 -1000 g. 30 A Cochrane review of developed country studies concluded that prophylactic topical ointment therapy increases the risk of coagulase negative staphylococcal infection and any nosocomial infection. 35 This does not appear to apply to the developing world, however, where Gram-negative organisms are more prominent among skin flora, 42 and invasive infections are caused by more virulent Gram-negative (eg, K. pneumoniae, Escherichia coli) and Gram-positive (eg, Staphylococcus aureus) organisms (AKM Zaidi, SA Ali, GL Darmstadt, S Qozi, ZA Bhutta. Serious bacterial infections among neonates and young infants in developing countries: evaluation of etiology and therapeutic management strategies in community settings, submitted for publication).…”

“…Conversely increased handling of extremely fragile skin during application of topical therapy in preterm infants, particularly those weighing Ͻ750 g, could conceivably cause further barrier injury and introduce additional infectious risks. In developing countries, however, where indwelling intravascular devices are used less frequently and levels of environmental contamination are much higher, 42 it is plausible that infections occur more often via sites amenable to topical therapy, such as microscopic sites of skin barrier compromise resulting from injury or maturational or nutritional underdevelopment. 11 The fact that adherence to, entry into and in some cases transcytosis through epithelial cells has been demonstrated for several of the virulent Gram-negative and Gram-positive bacteria that are principal agents of septicemia in neonates in developing countries further supports this contention.…”

Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: a review of the evidence

“…In general, however, neonates in developing country nurseries are challenged with much higher loads of potential pathogens. 29 The principal pathologic agents, and perhaps their virulence of infection, may also differ from developed countries. 3, 30, 31 Changing patterns of antibiotic use, varying antiseptic technique in hospital settings, the appearance of multidrug-resistant bacteria and variation in profiles between full term vs. preterm and healthy vs. unhealthy babies indicate the need for region-specific bacteriologic studies.…”

Clinical, Bacteriological Profile & Outcome of Neonatal Sepsis in a Tertiary Care Hospital

“…In most developing countries, gram-negative bacteria remain the major cause of neonatal sepsis 7,8 . These organisms have developed increased drug resistance over the last two decades 9 . On the other hand Group B Streptococcus (GBS) has been the most frequent etiological agent of neonatal sepsis in developed countries, being responsible for high morbidity and mortality 10 .…”