Onçağ Ozant, Cökmez Berna, Aydemir Söhret, Balcioğlu Taner
Dental Faculty, Department of Pedodontics, Ege University, Bornova-Izmir, Turkey.
Paediatr Anaesth. 2005 Mar;15(3):194-8. doi: 10.1111/j.1460-9592.2005.01503.x.
The aim of this study was to detect the risk of bacteremia from nasotracheal intubation in children undergoing dental treatment under general anesthesia.
Two 10 ml blood samples were taken, the first as a baseline and the second within 30 s following the nasotracheal intubation. The samples were inoculated into 5 ml aerobic and 5 ml anaerobic blood culture bottles. Following incubation in an automated blood culture system, bacteria were identified by using conventional biochemical methods and commercial identification systems. Mc Nemar's test was used to assess the findings statistically.
Of 74 patients only nine (12.3%) had positive blood cultures after the intubation and seven of these had been intubated without trauma. The incidence of bacteremia was significantly higher after atraumatic intubation (7/9) compared with traumatic intubation (2/9) (P < 0.05). The most common bacteria in positive cultures were Streptococcus viridans, four of 74 (5.4%).
Since the occurrence of bacteremia after nasotracheal intubation is hazardous for patients at risk for developing infective endocarditis, to prevent further complications prophylactic antibiotic treatment is recommended.
本研究的目的是检测在全身麻醉下接受牙科治疗的儿童经鼻气管插管引起菌血症的风险。
采集两份10毫升血样,第一份作为基线样本,第二份在经鼻气管插管后30秒内采集。将样本接种到5毫升需氧和5毫升厌氧血培养瓶中。在自动血培养系统中孵育后,使用传统生化方法和商业鉴定系统鉴定细菌。采用Mc Nemar检验对结果进行统计学评估。
74例患者中,只有9例(12.3%)在插管后血培养呈阳性,其中7例插管时无创伤。与有创插管(2/9)相比,无创插管后菌血症的发生率显著更高(7/9)(P < 0.05)。阳性培养物中最常见的细菌是草绿色链球菌,74例中有4例(5.4%)。
由于经鼻气管插管后发生菌血症对有感染性心内膜炎风险的患者有危害,为预防进一步并发症,建议进行预防性抗生素治疗。