Mechanism for Prevention of Infection in Preterm Neonates by Topical Emollients

Darmstadt, Gary L.; Ahmed, Saifuddin; Ahmed, Asm Nawshad Uddin; Saha, Samir K.

doi:10.1097/inf.0000000000000423

Cited by 40 publications

(46 citation statements)

References 23 publications

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“…aureus on the lesions of infants and adults with AD was reduced by 50–78% after a twice-daily application of emollients, including ointments, coconut oil, or olive oil for 1–4 months [ 23 , 24 ]. Accordingly, use of emollients in preterm neonates reduced the risk for skin infections [ 25 ]. In contrast, an observational study of children with AD in New Zealand showed no association between emollient use and S .…”

Section: Introductionmentioning

confidence: 99%

Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis

et al. 2018

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BackgroundEmollients are a mainstay of treatment in atopic dermatitis (AD), a disease distinguished by skin bacterial dysbiosis. However, changes in skin microbiota when emollients are used as a potential AD preventative measure in infants remain incompletely characterized.ResultsWe compared skin barrier parameters, AD development, and bacterial 16S ribosomal RNA gene sequences of cheek, dorsal and volar forearm samples from 6-month-old infants with a family history of atopy randomized to receive emollients (n = 11) or no emollients (controls, n = 12). The emollient group had a lower skin pH than the control group. The number of bacterial taxa in the emollient group was higher than in the control group at all sites. The Streptococcus salivarius proportion was higher in the emollient versus control groups at all sites. S. salivarius proportion appeared higher in infants without AD compared to infants with AD. A decrease in S. salivarius abundance was further identified in a separate larger population of older children demonstrating an inverse correlation between AD severity at sampling sites and S. salivarius proportions.ConclusionsThe decreased skin pH and the increased proportion of S. salivarius after long-term emollient use in infants at risk for developing AD may contribute to the preventative effects of emollients in high-risk infants.

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Section: Introductionmentioning

confidence: 99%

Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis

et al. 2018

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“…Topically applied oils could provide a physical barrier to skin disruption and/or accelerate and/or augment skin barrier development, resulting in reduced microorganism invasion, hospital-acquired infections and associated mortality 12–14. A recent analysis of data from Bangladesh suggested that preservation of skin integrity was associated with reduced risk of infection 15. Skin applications of emollients can also reduce transepidermal water loss16 17 and conserve heat and energy to promote physical growth 18.…”

Section: Introductionmentioning

confidence: 99%

Effect of emollient therapy on clinical outcomes in preterm neonates in Pakistan: a randomised controlled trial

Salam

Darmstadt

Bhutta

2015

Arch Dis Child Fetal Neonatal Ed

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“…A recent trial of oil massage of preterm infants with coconut oil has produced similar results. 79 While an emollient appears to work by preserving skin integrity and protecting from skin injury, 80,81 this intervention is also hypothesized to work by helping accelerate maturation of skin-barrier function (partially through reducing cutaneous signs of essential fatty acid deficiency), thereby reducing likelihood of transcutaneous acquisition of invasive pathogens. Ongoing randomized community-based trials are addressing these questions in large rural populations in Nepal and India.…”

Section: Topical Emollient Therapymentioning

confidence: 98%