Effect of topical emollient treatment of preterm neonates in Bangladesh on invasion of pathogens into the bloodstream
Effect of topical emollient treatment of preterm neonates in Bangladesh on invasion of pathogens into the bloodstream
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DOI：
10.1203/pdr.0b013e3180459f75
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发表时间：
2007-05-01
影响因子：
3.6
通讯作者：
Ahmed, Saifuddin
中科院分区：
文献类型：
--
作者：
Darmstadt, Gary L.;Saha, Samir K.;Ahmed, Saifuddin
在发展中国家，外用润肤剂治疗可降低早产儿严重感染的发生率和死亡率。我们测试了润肤剂治疗是否减少了皮肤上病原体的负担和/或防止细菌移位。胎龄< 33周的新生儿被随机分配到向日葵籽油（SSO）或Aquaphor治疗组或未治疗的对照组。在入组时和第3天、第7天以及此后每周采集皮肤状况评分和皮肤培养物，并采集疑似院内感染的血培养物。为了进行分析，将血培养物与血培养前0-3天获得的皮肤培养物配对。与未治疗的对照组相比，使用任一润肤剂治疗的患者在第3天的皮肤状况评分更好;然而，两组之间的皮肤植物群相似。与对照组相比，SSO组显示出与阴性血培养相关的假阳性（FP）皮肤培养（即皮肤植物群被阻止进入血液）的几率增加了72%。SSO的局部治疗减少了病原体从皮肤表面进入早产儿血液的通道。
Topical emollient therapy may reduce the incidence of serious infections and mortality of preterm infants in developing countries. We tested whether emollient therapy reduced the burden of pathogens on skin and/or prevented bacterial translocation. Neonates < 33 wk gestational age were randomized to treatment with sunflower seed oil (SSO) or Aquaphor or the untreated control group. Skin condition score and skin cultures were obtained at enrollment and on d 3, 7, and weekly thereafter, and blood cultures were obtained for episodes of suspected nosocomial sepsis. For analysis, blood cultures were paired with skin cultures obtained 0-3 d before the blood culture. Skin condition scores at 3 d were better in patients treated with either emollient compared with untreated controls; however, skin flora was similar across the groups. The SSO group showed a 72% elevated odds of having a false-positive (FP) skin culture associated with a negative blood culture (i.e. skin flora blocked from entry into blood) compared with the control group. Topical therapy with SSO reduced the passage of pathogens from the skin surface into the bloodstream of preterm infants.