Neonatal Skin

Principal Investigator:

Jennifer Schoch, MD – University of Florida

Overview:

The study sought to characterize the cutaneous microbiome in a cohort of premature infants, and explore the impact of early postnatal antibiotic exposure on the cutaneous microbiome. Bacterial colonization of both the infant gut and skin are likely critical in immune system development, though little is known about the parallel assembly of the microbiome across sites. This study built on the previous work on the impact of antibiotics on the intestinal microbiome, metabolome, and inflammatory responses in premature infants. The addition of cutaneous microbiome sampling to this existing cohort allowed for comparison between the development of the microbiome in both the skin and gut within the same subject. It also allowed the exploration the impact of antibiotic exposure on cutaneous microbial diversity and adverse outcomes including sepsis. Finally, in the event of adverse outcomes, cultured pathogenic organisms will be compared to microbial profiles of the skin and intestine to explore which site was likely breached. We hypothesized that antibiotic exposure was associated with a loss of microbial diversity across both the cutaneous and intestinal microbiome, and that these effects extend beyond the duration of the antibiotic exposure. We also suspected that the altered microbial ecology would be associated with a higher incidence of adverse outcomes, including late onset sepsis (LOS), which can be associated with a breach in the intestinal, mucosal, or cutaneous barrier.

Status:

This study was funded as a 2017 PeDRA Pilot Grant and is now complete. Final results were presented at the 2019 Annual Meeting of the Society for Pediatric Dermatology.

Principal Investigator:

Christine Lauren, MD – Columbia University

Overview:

The aim of this retrospective, multi-center study is to document the current practices of pediatric dermatologists across North America and establish recommendations for the evaluation and management of afebrile neonates with pustulosis.

Status:

Data collection underway.

Principal Investigator:

Christine Lauren, MD – Columbia University

Overview:

The Survey of Skincare in Neonates to Update Guidelines (SoSNUG) project proposes to assess the practices and protocols regarding neonatal skin care that are currently utilized in newborn nurseries and NICUs across the United States and Canada. Neonates are most often cared for by skilled physicians and nurses, however pediatric dermatologists have specialized training in caring for the skin of newborns. Although guidelines exist in publication, the reality of clinical practice does not necessarily correspond to recommendations. Based on preliminary data, there are many aspects of routine neonatal skin care that vary within and among medical centers providing care to newborns. As pediatric dermatologists, we wish to publish clear and informative guidelines for neonatal skin care to ensure a unified practice. In order to provide the most effective guidelines, as a first step we seek to improve our understanding of current practices in neonatal skin care by means of a survey.

Status:

Data collection underway.

This project received a 2019 PeDRA Study Support Grant to analyze complex survey results. Analysis is being done at the Columbia University Irving Medical Center for Biostatistics, Epidemiology, and Research Design.

Principal Investigator:

Wynnis Tom, MD – UCSD

Status:

Active design.