Cases Of Omphalitis Research Articles

Prevalence, molecular characterization, and antimicrobial resistance among Escherichia coli, Salmonella spp., and Staphylococcus aureus strains isolated from Egyptian broiler chicken flocks with omphalitis.

Bacterial Omphalitis has been reported as a significant cause of mortalities in newly hatched broiler chicks. This study aimed to assess the occurrence of omphalitis among broiler chickens in Gharbia governorate in Egypt. In addition, the bacteria associated with the occurrence of omphalitis in broiler chickens were also investigated and characterized. For this purpose, 43 farms in that area were surveyed. The comparative levels of omphalitis caused by Escherichia coli (E. coli), Salmonella spp., and Staphylococcus aureus (S. aureus) were screened in 129 chicks. The drug resistance to eight commonly used antimicrobials in Egyptian poultry farms was screened using the disk diffusion method. The overall incidence rate of omphalitis was 37.21%. In birds with omphalitis, the co-prevalence of S. aureus, Salmonella spp., and E. coli was 87.5%. When compared to healthy flocks, broiler chicks with omphalitis caused by Salmonella spp., E. coli, and S. aureus had a greater mortality rate in the first week of life. However, there were no significant differences in the mortality cases caused by these pathogens. Eighty-seven percent of the cases of omphalitis were linked to E. coli and 75% to Salmonella spp. and S. aureus. From the yolk sac of broiler chicks with omphalitis, E. coli, Salmonella spp., and S. aureus were isolated at rates of 87.5%, 62.5%, and 45.8%, respectively. The isolates of E. coli and Salmonella spp. exhibited great sensitivity to gentamycin and Tetracycline; however, the strongest drug resistance was observed toward cefpodoxime, sulphamethoxazole and trimethoprim, ampicillin, and amoxycillin and clavulanic acid. The recovered isolates of S. aureus showed susceptibility to chloramphenicol (72.37%), oxytetracycline (81.82%), and erythromycin (81.82%). However, every S. aureus isolate that was found resistant to amoxycillin and clavulanic acid, penicillin G and oxacillin. of blaTEM, blaSHV, and blaCTX-M genes has been proposed as the genetic cause of β-lactam antibiotic resistance in Salmonella spp. and E. coli. MecA and blaZ; however, were found in every strain of S. aureus. The frequency of omphalitis and its associated mortalities was comparatively high in Gharbia governorate. More efforts should be made to adopt strict hygienic standards for controlling and preventing such disease and this will consequently lead to minimizing the use of antimicrobials in poultry farms.

Surgical Treatment of Postpartureint Omphalitis in Calves

The study was conducted in Al-Muthanna Province-Iraq from January to June 2022, aimed at diagnosing and treating cases of omphalitis in newborn calves. The study included 15 calves infected with umbilical inflammation for 3-30 days after parturition. The animals were divided into three groups according to the severity of the infection and the clinical signs. The study showed that omphalitis in calves occurs in the first days after parturition due to infection of the navel with microorganisms that lead to inflammation and the emergence of clinical signs that include swelling and abscess collection, in addition to high temperature of the animal and lack of appetite. Some cases necessitated surgical intervention to open the swelling and drain the abscess by placing bacteria-killing solutions inside the wound to ensure that the place is sterilized and that the abscess does not collect again. The cases were also treated with antibiotics, antipyretics, and vitamins with repeated treatment for several days until the animal fully recovered. Keywords:- surgical treatment, omphalitis, calves.

Surgical Approach in Calves with Omphalitis

Background:Pathological changes in the umbilical region are common in calves. Among such alterations, omphalitis is included. This term is used to define inflammation and infection of the external structures of the umbilicus. According to the affected structures, it can be subclassified into omphalophlebitis, omphaloarteritis, omphalourachitis and panvasculitis. These inflammations are usually associated with bacterial infections. There are predisposing conditions that include inadequate handling such as poor hygiene and neglect of primary care. Omphalitis can affect the animal in a multisystemic way, compromising its well-being and bringing economic losses. In treatment, the use of antimicrobials does not always solve the problem. Thus, surgical treatment can be used, which has good results and should be the choice in the disease. The objective of this work is to report 30 cases of omphalitis in calves, submitted to surgical or conservative treatment.Materials, Methods & Results: Thirty cases of omphalitis in calves treated in the routine of the Veterinary Hospital of the Paranaense University was analyzed. On physical examination, the animals presented fever, apathy, hyporexia or anorexia and increase of umbilical volume, usually with purulent secretion. Some animals had sepsis and arthritis. In animals with sepsis, hyperemia of the episcleral vessels, dehydration and severe apathy were observed. In calves with arthritis, increased joint volume, pain on palpation and lameness were observed. In animals where the owners did not authorize the surgery, treatment was instituted with sulfadoxine and flunixim meglumine. In dehydrated calves, fluid therapy was used. Animals that were surgically treated received the same clinical treatment protocol as non-operated animals. The surgical procedure was performed under general anesthesia and consisted of resection of the affected umbilical structures. Omphalophlebitis was the most common illness. The most frequent complication was sepsis. Calves treated surgically had a higher survival rate (86.66%) than those treated clinically (46.67%).Discussion: The clinical signs presented by all animals converged with the literature, allowing for clinical diagnosis. Clinical examination is essential for diagnosis in omphalitis cases. Complementary methods include ultrasound, thermography and laparoscopy, which are important to identify changes in intra-abdominal umbilical structures. Accurate diagnosis of the involved structures was only possible in animals surgically, as well as alterations in organs such as the liver and bladder. There is great variability related to the umbilical structures involved, according to initial care, breeds, seasonality or even the method of conception. Unlike what is observed in the literature, in the present study, there was a higher prevalence of omphalophlebitis, demonstrating variability in relation to the umbilical structures involved. Sepsis, observed in 16.7% of cases, results from bacterial ascension of the umbilical structures. Lameness due to polyarthritis was found in 10% of animals. Meningoencephalitis was observed in 3.3%. Hepatic and retroperitoneal abscedation were observed in 6.7% and 3.3% of cases, respectively. Conservative treatment with antibiotics and local antiseptics has a limited effect on this type of condition, which was proven in the presentstudy, since the survival rate was statistically higher in animalssurgically treated.Keywords: surgery, umbilical structures, bovine, neonate.Descritores: cirurgia, estruturas umbilicais, bovinos, neonato.Título: Surgical Approach in Calves with Omphalitis

Omphalitis Leading to Urachitis and Acute Vascular Changes in a Buffalo Calf: An Insight into Macro and Microscopic Pathologic Changes

Omphalitis in domestic animals being considered as commonest ailment after birth, are in general, poorly reported for its uneventful recovery. Several previously reported cases endeavoured to highlight involvement of pathogenic organism in progression of the condition with little elaboration to pathologic changes occurred. Moreover, description of omphalitis in buffalo calf was never been attempted. Therefore this report intends to elaborate the pathology noted around umbilical zone in a buffalo calf possibly arisen to infectious etiology with special reference to complicated involvement of urachus, eventual haemoperitoneum and striking acute vascular changes of multi-systemic organs. Intriguingly, this report also attempted to review few recent cases of omphalitis seen in different animals along with their paramount etiologic causes.

Eau de Dalibour vs. Alcohol for Umbilical Cord Care

This study was conducted to compare the effects of Eau de Dalibour and ethanol on preventing omphalitis and also on umbilical cord separation time in neonates. In this clinical trial, 178 randomly selected, healthy term neonates were investigated. To disinfect the umbilical cords, Eau de Dalibour was used for 84 infants (case group) and ethanol for 94 infants (control group). No cases of omphalitis were observed in either group. Umbilical cord separation time was significantly shorter in the Eau de Dalibour group than in the ethanol group: 4.04 ± 1.61 days vs. 6.3 ± 1.82 days, p = 0.001. This study revealed that although Eau de Dalibour and ethanol were equally effective in preventing the incidence of omphalitis in neonates, Eau de Dalibour induced the separation of umbilical cord significantly quicker in the infants. Thus, Eau de Dalibour could be used as a suitable replacement for ethanol in neonates' umbilical cord care.

Correlação entre os métodos de concepção, ocorrência e formas de tratamento das onfalopatias em bovinos: estudo retrospectivo

Alguns problemas têm sido observados nos bezerros produtos da técnica fertilização in vitro, dentre esses a elevada casuística de onfalopatias. A partir dessa observação, objetivou-se com este trabalho realizar um estudo retrospectivo da correlação entre os métodos de concepção e a ocorrência de onfalopatias em bovinos e descrever os resultados obtidos a partir dos tratamentos conservativo e cirúrgico. Foram utilizados 44 bovinos atendidos no Hospital Veterinário da Unesp, Campus de Araçatuba, com idade variando de um dia a 12 meses entre os anos de 2003 e 2007. Desses bovinos 27 eram provenientes de fertilização in vitro (FIV), 12 de inseminação artificial (IA), dois de monta natural (MN) e três de transferência de embriões (TE). O diagnóstico clínico-cirúrgico revelou que todos apresentavam afecções umbilicais, sendo 22 casos de persistência de úraco, oito de onfaloflebite, oito de hérnias umbilicais, cinco de onfalites e um de fibrose umbilical. Inicialmente e no pós-operatório administrou-se em todos os animais, uma vez ao dia, durante dez dias, 3mg/kg de ceftiofur sódico pela via intravenosa (IV). Nos casos de infecção grave ou irresponsiva a terapia antimicrobiana inicial, acrescentou-se 6,6mg/kg, durante sete dias de sulfato de gentamicina IV. A antissepsia do umbigo, com tintura de iodo a 2%, foi instituída duas vezes ao dia, nos casos tratados conservativamente, enquanto que os bovinos submetidos à cirurgia receberam 1,1mg/kg de flunixin meglumine IV, uma vez ao dia, por cinco dias consecutivos. Dos 22 animais diagnosticados com persistência de úraco, 10 apresentavam drenagem de urina pelo umbigo e receberam 2mL de tintura de iodo 10% no interior do úraco, sendo 15 tratados com a excisão cirúrgica, especialmente, devido à formação de divertículo vésico-uracal. Todos os animais que apresentavam onfaloflebite e hérnia umbilical foram submetidos à cirurgia. Já dos cinco casos de onfalite, três foram tratados conservativamente. A análise dos diferentes métodos de concepção, correlacionados à ocorrência de onfalopatias, sugere que os animais provenientes de FIV, apresentam maior frequência de persistência de úraco (66,7%), e aqueles concebidos por IA, maior frequência de hérnia umbilical (58,4%), O tratamento cirúrgico foi mais eficiente que a terapia conservativa. Essa última apresentou melhores resultados nos casos descomplicados e precocemente diagnosticados.

Higher Rate of Cord-Related Adverse Events in Neonates with Dry Umbilical Cord Care Compared to Chlorhexidine Powder

Objective: Best practice for umbilical cord care (UC) still remains controversial in developed countries with aseptic perinatal care. A bicenter randomized clinical trial was performed to evaluate the efficacy of chlorhexidine (CX) powder versus dry cord care (DC) for UC. Patients and Methods: All neonates of two neonatal care units were invited to take part in the study. Participants were randomized to either DC or UC with CX powder (0.1%). Primary study outcome was the cord separation time. Secondary outcomes were omphalitis, granuloma of the umbilical ground, adverse events and parents’ treatment satisfaction. The outcome parameters were documented at a hospital-located study visit 10–14 days after birth. Results: 669 neonates were enrolled in the trial. 337 were randomized to receive CX powder for umbilical cord care, 332 to DC. Cord separation time was 7.0 ± 2.5 days in CX-treated neonates and 7.8 ± 2.9 days in DC (p < 0.001). There were 9 cases of omphalitis, 2 in the CX group, 7 in the DC group (p = 0.1). No difference in the occurrence of umbilical granuloma between the treatment regimens was detected. Neonates randomized to CX were less likely to have an adverse event (140 in 109 subjects vs. 205 in 149 subjects in the DC neonates; p = 0.001). Half of these adverse events were cord-related. Neonates randomized to DC had nearly twice as many cord-related adverse events as those with CX treatment (CX: 58 in 54 patients vs. DC: 110 in 97 patients; p < 0.001). Parents’ treatment satisfaction was significantly higher in the neonates with CX cord care. Conclusions: Cord-related adverse events in neonatal umbilical cord care remain a clinical issue. Even in an aseptic birth context in a developed country, cord care with CX powder showed a reduction of cord-related adverse events.

Umbilical Cord Care: A Pilot Study Comparing Topical Human Milk, Povidone‐Iodine, and Dry Care

To compare the incidence of omphalitis among three groups, each using a different type of newborn cord care: povidone-iodine, dry care, and topical human milk. Case control. A large urban university hospital in Turkey and participant homes after discharge. 150 healthy, full-term newborns and their mothers. Umbilical cord care consisted of one of three methods: topical application of povidone-iodine twice daily, topical application of mother's milk twice daily, or dry care (keeping the cord dry and clean). Outcome was measured in terms of the presence or absence of omphalitis and the number of days elapsed before cord separation. An ongoing questionnaire was administered by telephone every other day after the participants left the hospital. In addition to demographic information, the cord separation day and any signs of omphalitis were recorded in the questionnaire. There were no significant differences between the three groups in terms of omphalitis occurrence. Two cases of omphalitis were observed (one in the human milk group, one in the povidone-iodine group). Interestingly, babies in the dry care or topical human milk group had shorter cord separation times than those in the povidone-iodine group. The cultural practice of applying human milk to the umbilical cord stump appears to have no adverse effects and is associated with shorter cord separation times than are seen with the use of antiseptics.

Changes in Newborn Bathing Practices May Increase the Risk for Omphalitis

Aseptic cord care, in conjunction with antibacterial skin care, has reduced the incidence of omphalitis specifically caused by Staphylococcus aureus. However, this practice has resulted in the emergence of resistant organisms that may pose a greater risk for newborn infections. Subsequently, many institutions have changed to dry cord care and nonantiseptic whole-body baths, a practice that has not been adequately studied to determine potential infectious risks. Three cases of omphalitis occurring after an institutional change to nonantiseptic whole-body baths are presented. Clinical diagnosis and treatment of omphalitis are reviewed. Recommendations for surveillance of omphalitis are offered.

Umbilical Cord Care: The Effect of Eight Different Cord-Care Regimens on Cord Separation Time and Other Outcomes

In this study we evaluate the effect of eight cord-care regimens on cord separation time and other secondary outcomes: omphalitis, sepsis, death, cord bleeding, compliance, satisfaction or dissatisfaction with regard to the type of treatment, umbilical cord colonization – in 1,535 healthy term infants. The eight cord-care regimens studied were: 70% alcohol, natural drying, salicylic sugar powder, triple dye, micronized green clay powder, colloid silver-benzyl-peroxide powder, neomycin-bacitracin powder, 1% basic fuchsine. None of the newborns developed sepsis or died and we found only sporadic cases of omphalitis. With regard to cord separation time the best results were obtained with salicylic sugar powder (5.6 ± 2.3 days) and green clay powder (6.7 ± 2.2 days). Both forms of treatment proved to be more effective (p < 0.05) than all the others. We found that salicylic sugar powder allows for early cord detachment resulting in excellent parent treatment compliance and reduction of their concern, notwithstanding higher percentages of cord bleeding. The rate of positive umbilical swabs was low and was significantly higher only than the results obtained with neomycin-bacitracin powder treatment. This study demonstrates that, in hospital nurseries of developed countries, salicylic sugar powder can be effectively and safely used for umbilical cord care of healthy term infants.

Repair of gastroschisis with preservation of the umbilicus

A simplified technique for the repair of gastroschisis without the need to excise the umbilicus or make a fascial incision has been developed. First, the abdominal wall is stretched and the viscera are reduced. Next, the skin and subcutaneous tissue are elevated from the fascia for 1.5 cm around the defect and the fascia is closed transversely with interrupted sutures. The skin is also closed transversely. The umbilical stump is left intact. Eight of nine consecutive patients with gastroschisis were able to undergo repair by this technique. The average hospital stay was 35.6 days. There were no cases of omphalitis or cellulitis of the abdominal wall, but one child has a small umbilical hernia. All have a near normal-appearing umbilicus. This simpler technique for the repair of gastroschisis is quicker and less traumatic, and gives a better cosmetic result than the conventional method.

Necrotizing fasciitis. A serious sequela of omphalitis in the newborn.

We reviewed all cases of omphalitis seen at Childrens Hospital of Los Angeles from 1961 to 1981. One hundred and forty patients were seen and, of these, eight had necrotizing fasciitis. All patients with necrotizing fasciitis acquired omphalitis at home, making the incidence of necrotizing fasciitis over 10% in patients with community acquired omphalitis. Most of the infants appeared relatively well on admission with no fever but had a marked leukocytosis. The disease rapidly spread to involve most of the abdominal wall over a period of several hours to days. Seven of the eight patients died (87.5%). Five patients were operated upon but despite extensive resection of involved tissue, four died within 24 hours of surgery. A polymicrobial flora of both gram positive and gram negative bacteria was recovered in all patients cultured. The high incidence of necrotizing fasciitis following omphalitis in the newborn with its attendant morbidity and mortality mandates close observation of these infants with early surgical intervention if there is any question of the diagnosis.

III. Bacterial Contamination of the Umbilicus

In December 1957, two cases of omphalitis occurred in one of the nurseries. Hemolytic streptococcus and S. aureus were isolated from the umbilicus in each case. These findings prompted us to take umbilical swabs from all the babies in the two nurseries on the same ward. Table XIX shows that on this occasion 83% of the 23 cords sampled were contaminated with Hemolytic streptococcus and 78% with S. aureus. When it was noted that such a high percentage of cords were contaminated with pyogenic streptococci and staphylococci, it was decided to treat all babies by painting the cords once daily with aqueous benzalkonium, Zephiran®, (1:1000). After this procedure had been in use for 5 weeks, surveys showed that 67% of 57 infants' cords still carried Hemolytic streptococcus and 68% carried S. aureus (Table XIX). As the Zephiran® treatment had not reduced the number of either streptococci or staphylococci appreciably, triple-dye was applied daily to the cord stumps (Jellard, J.:Brit. M. J., 1:925, 1957). With this method, although streptococci and staphylococci were not immediately eliminated, the results after 6 weeks showed a low rate of contamination (Table XIX). Although not shown in the Table, on the occasion of our last survey, when 31 cords were sampled, no streptococci were recovered. The presence of such a high degree of streptococcal cord contamination was disturbing. An explanation for this was sought by attempting to locate streptococcal throat-carries amongst the nursery personnel. However, pyogenic streptococci were not recovered from their throats. No case of streptococcal puerperal sepsis had been reported from the maternity wards of the hospital for more than a year.