Effect of less frequent bathing of preterm infants on skin flora and pathogen colonization

Abstract

Objective: To determine if less frequent bathing alters colony count or type of organism in skin flora of preterm infants.

Design: Descriptive, repeated measures study.

Setting: A regional neonatal intensive-care unit.

Participants: Forty-five preterm infants, 31 weeks mean gestational age (SD +/- 1.6 weeks) and 17 days mean postnatal age (SD +/- 3.7 days).

Interventions: Before the study, all infants received a bath every other day. On Day 1 of the study, a routine sponge bath was given, then no further bathing was performed for 4 days.

Main outcome measure: Serial axillary skin cultures to identify the number of colony forming units (CFU) and type of organism were obtained within 30 minutes of the bath on Day 1 and at the same time on Days 2, 3, and 4.

Results: Normal skin flora CFU count, predominantly coagulase-negative staphylococci, increased within 48 hours after bathing compared to values 30 minutes after bathing. There were no differences in normal skin flora CFU on Days 2, 3, and 4. Pathogens were identified in 12 infants for at least one time point during the study. Significantly fewer pathogens were found in the cultures over time, despite longer interval since bathing, and no infant developed symptoms of infection during the study period.

Conclusion: Findings from this study suggest that the frequency of bathing of preterm infants can be reduced without increasing the risk of infection.