Umbilical Cord Stump Infections in Central Uganda: Incidence, Bacteriological Profile, and Risk Factors

Josephine Tumuhamye (), Halvor Sommerfelt, James K. Tumwine, David Mukunya, Grace Ndeezi, Olive Namugga, Freddie Bwanga, Hans Steinsland and Victoria Nankabirwa
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Josephine Tumuhamye: Centre for Intervention Science for Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
Halvor Sommerfelt: Centre for Intervention Science for Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
James K. Tumwine: Department of Paediatric and Child Health, Makerere University, Kampala P.O. Box 7062, Uganda
David Mukunya: Department of Community and Public Health, Busitema University, Mbale P.O. Box 236, Uganda
Grace Ndeezi: Department of Paediatric and Child Health, Makerere University, Kampala P.O. Box 7062, Uganda
Olive Namugga: Centre for Intervention Science for Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
Freddie Bwanga: Department of Immunology and Molecular Biology, Makerere University, Kampala P.O. Box 7062, Uganda
Hans Steinsland: Centre for Intervention Science for Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
Victoria Nankabirwa: Centre for Intervention Science for Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway

IJERPH, 2022, vol. 19, issue 23, 1-12

Abstract: Umbilical cord stump infection (omphalitis) is a risk factor for neonatal sepsis and death. We assessed the incidence of omphalitis, described the bacteriological and antibiotic-resistance profile of potentially pathogenic bacteria isolated from the umbilical cord stump of omphalitis cases, and evaluated whether bacteria present in the birth canal during birth predicted omphalitis. We enrolled 769 neonates at birth at three primary healthcare facilities and followed them for 28 days with scheduled visits on days 3, 7, 14, and 28. Cox regression models were used to estimate the rates of omphalitis associated with potential risk factors. Sixty-five (8.5%) neonates developed omphalitis, with an estimated incidence of 0.095 cases per 28 child-days (95% CI 0.073, 0.12). Potentially pathogenic bacteria were isolated from the cord stump area of 41 (63.1%) of the 65 neonates with omphalitis, and the most commonly isolated species were Escherichia coli ( n = 18), Klebsiella pneumoniae ( n = 10), Citrobacter freundii ( n = 5), and Enterobacter spp. ( n = 4). The Enterobacteriaceace isolates were resistant to gentamicin (10.5%, 4/38), ampicillin (86.8%, 33/38), and ceftriaxone (13.2%, 5/38). Delayed initiation of breastfeeding was associated with an increased risk of omphalitis (aHR 3.1; 95% CI 1.3, 7.3); however, vaginal colonization with potentially pathogenic bacteria did not predict omphalitis.

Keywords: omphalitis; umbilical cord stump infections; neonates; newborns; incidence rate; incidence proportion; antimicrobial-resistance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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