Chuo C B, Timmons M J
Plastic Surgery, Bradford Royal Infirmary, West Yorkshire, United Kingdom.
Cleft Palate Craniofac J. 2005 May;42(3):272-6. doi: 10.1597/03-108.1.
Bacterial infections can complicate any surgery. Knowledge of potentially pathogenic bacterial flora in children with cleft lip and palate allows appropriate risk management, including the need for prophylactic antibiotics. This project reviewed the bacteriology of children before primary cleft lip and palate surgery.
A retrospective study of the results of nose, throat, and ear microbiological swabs taken from children, aged 1 to 26 months, before repair of primary cleft lip, cleft palate, or both was carried out. Swabs with Staphylococcus aureus and beta-hemolytic streptococcus were considered positive.
From October 1987 to May 2002, 321 primary cleft lip or palate operations were performed in 250 patients. Results from 326 sets of preoperative swabs were available, including five repeat sets from patients whose operations were postponed. There were 235 (72.1%) negative sets and 91 (27.9%) positive sets. Of the positive swabs, 86 sets grew S. aureus, and 10 sets grew beta-hemolytic streptococcus.
Children with unrepaired cleft lip and palate have a significant risk of carrying S. aureus and a small risk of carrying beta-hemolytic streptococci. These risks need to be considered when deciding on protocols for preoperative bacteriology tests and prophylactic antibiotics.
细菌感染会使任何手术变得复杂。了解唇腭裂患儿潜在的致病菌群有助于进行适当的风险管理，包括是否需要预防性使用抗生素。本项目回顾了唇腭裂一期手术前患儿的细菌学情况。
对1至26个月大的患儿在唇裂、腭裂或唇腭裂一期修复术前采集的鼻、咽、耳微生物拭子结果进行回顾性研究。金黄色葡萄球菌和β溶血性链球菌拭子检测结果为阳性。
1987年10月至2002年5月，对250例患者进行了321例唇腭裂一期手术。获得了326份术前拭子检测结果，其中包括5例手术延期患者的重复检测结果。235份（72.1%）检测结果为阴性，91份（27.9%）为阳性。在阳性拭子中，86份培养出金黄色葡萄球菌，10份培养出β溶血性链球菌。
未修复唇腭裂的患儿携带金黄色葡萄球菌的风险较高，携带β溶血性链球菌的风险较低。在制定术前细菌学检测方案和预防性使用抗生素时，需要考虑这些风险。
