title: Effect of topical emollient treatment of preterm neonates in Bangladesh on invasion of pathogens into the bloodstream.
abstract: 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.
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA. gdarmsta@jhsph.edu
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: A S M Nawshad Uddin
authors.initials: AS
authors.lastname: Ahmed
authors.forename: Yoonjoung
authors.initials: Y
authors.lastname: Choi
authors.forename: M A K Azad
authors.initials: MA
authors.lastname: Chowdhury
authors.forename: Maksuda
authors.initials: M
authors.lastname: Islam
authors.forename: Paul A
authors.initials: PA
authors.lastname: Law
authors.forename: Saifuddin
authors.initials: S
authors.lastname: Ahmed
mesh_terms: D000287:Administration, Topical; D001459:Bangladesh; D004643:Emollients / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D017053:Infection Control / Q000379:methods; D010938:Plant Oils / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology*; D000074242:Sunflower Oil
chemical_list: D004643:Emollients; D010938:Plant Oils; D000074242:Sunflower Oil