Microbiology of necrotizing fasciitis associated with omphalitis in the newborn infant.

OBJECTIVE

The purpose of this study was to report the aerobic and anaerobic microbiology of periumbilical necrotizing fasciitis in newborn infants.

STUDY DESIGN

Retrospective review was done of the author's 20-year experience.

RESULTS

Specimens obtained from 11 newborn infants with periumbilical necrotizing fasciitis were cultured for aerobic and anaerobic bacteria. A total of 38 bacterial isolates was recovered: 21 aerobic and facultative and 17 anaerobic. Aerobic or facultative bacteria only were present in 1 specimen (9%), anaerobes only in 2 (18%), and mixed aerobic and anaerobic flora in 8 (73%). Multiple organisms were recovered from all instances and the number of isolates varied from two to six (average 3.5 isolates per specimen). The predominant isolates were Peptostreptococcus sp. (7 isolates); Bacteroides fragilis group (6); streptococcus group B (4); and Staphylococcus aureus, streptococcus group D, Escherichia coli, and Proteus mirabilis (3 each). All patients underwent extensive debridement and resection, and they received supportive and antimicrobial therapy. Six (55%) of the patients died.

CONCLUSIONS

These findings illustrate the polymicrobial aerobic-anaerobic flora of periumbilical necrotizing fasciitis.