What are the common causes of omphalitis (belly button infections)?

From the Guidelines

Belly button infections, or omphalitis, are most commonly caused by bacterial contamination, with Staphylococcus aureus being the most frequently reported organism, as well as other pathogens like group A and group B Streptococci and Gram-negative bacilli including Escherichia coli, Klebsiella species, and Pseudomonas species 1. The causes of omphalitis can be attributed to various factors, including:

• Bacterial colonization of the umbilical cord in newborns, which can be influenced by the method of caring for the umbilical cord after birth, as well as sources of potentially pathogenic bacteria such as the mother's birth canal and nonsterile hands of delivery assistants 1
• Poor hygiene in adults, which can lead to the introduction of bacteria into the umbilical area
• Other risk factors, such as navel piercings, excessive sweating, obesity, and underlying conditions like diabetes that impair immune function It is essential to note that the devitalized umbilical cord provides an ideal medium for bacterial growth, and sources of potentially pathogenic bacteria can include the mother's birth canal and various local bacterial sources at the site of delivery 1. In terms of prevention, proper hygiene, keeping the area dry, and prompt attention to any signs of redness, discharge, or pain are crucial in preventing omphalitis, as well as avoiding activities that can introduce bacteria to the umbilical area, such as swimming in contaminated water or having recent abdominal surgery. The infection develops when bacteria enter through breaks in the skin around the navel, with risk factors including compromised immunity, excessive moisture in the area, and foreign bodies like lint accumulation, highlighting the importance of maintaining good hygiene and monitoring for any signs of infection.

From the Research

Common Causes of Belly Button Infections (Omphalitis)

• Bacterial infections are a primary cause of omphalitis, with various bacteria being implicated in different studies 2, 3, 4, 5.
• The most common pathogens isolated from umbilical pus include:
  • Staphylococcus aureus, including methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) 2, 3.
  • Streptococcus pyogenes 2.
  • Group B beta-hemolytic streptococci 2.
  • Pseudomonas spp. 2.
  • Aeromonas spp. 2.
  • Klebsiella spp. 2.
• Other factors that may contribute to the development of omphalitis include:
  • Septic delivery, especially home delivery 4.
  • Prematurity 4.
  • Being small for gestational age 4.
  • Folliculitis and infections associated with pilonidal cysts and piercing of the umbilical area 6.
  • Infected remnants of the allantois or the omphalomesenteric (vitelline) duct 6.
• Anaerobic bacteria, such as Bacteroides fragilis group, Fusobacterium spp., Peptostreptococcus spp., and Clostridium spp., can also cause omphalitis, often in combination with aerobic and facultative bacteria 5.