Omphalitis neonatorum.

Clinicobacteriological profile of omphalitis neonatorum was analysed in this prospective study which comprised 4776 neonates (4410 hospital-born, 366 deliveries at home). The incidence of omphalitis in the hospital-born babies was 2.3%. About 21.3% babies delivered at home were admitted for neonatal sepsis, meningitis, birth asphyxia, etc. They were found to be concomitantly suffering from omphalitis. Improper severing of the umbilical cord, application of oily substances on the umbilical stump and unhygienic rearing practices during neonatal period were some of the important predisposing factors. The fall of the umbilical stump and the diagnosis of omphalitis neonatorum was made significantly earlier (p < 0.001) in the hospital-born babies and none of them developed sepsis. The institution of therapy for umbilical sepsis was considerably delayed in the babies delivered at home and the omphalitis was the probable cause of sepsis in 46.6% cases. The Gram-negative organisms were responsible for omphalitis in 57.1% cases. Klebsiella was the commonest Gram-negative organism. Its incidence was more among the babies delivered at home signifying a potentially infective environment in the community. Gram's stain was a reliable and easy method for grossly identifying the organism in the umbilical smear.