Risk of infection associated with umbilical vein catheterization. A prospective study in 75 newborn infants.

To determine the risk of infection created by catheterization of the umbilical vein per se, 75 jaundiced, but otherwise healthy, newborn infants subjected to exchange transfusion were studied. Twenty-three were given antibiotics because of premature rupture of membranes. Fifty-three percent of the umbilici were contaminated before the insertion of the catheter, even after a very careful cleansing procedure. Sixty-two percent of the catheters were colonized upon removal. Bacteria were isolated from 44.9% of blood specimens drawn via the catheter at the onset of ET, but only in 14% of blood specimens drawn in the same way at the end of the procedure. Seven newborn infants (10%) were found to be bacteremic 4-6 after ET; four of these infants were not treated and were able to eliminate the bacteremia. Systemic antibiotic therapy did not reduce the overall prevalence of colonization of cord and catheter of positive blood cultures pre- and postexchanges transfusion or the rate of bacteremia.