Honda Hiromi, Funahara Madoka, Nose Kanako, Aoki Megumi, Soutome Sakiko, Yanagita Kenichi, Nakamichi Atsuko
School of Oral Health Sciences Faculty of Dentistry Kyushu Dental University, Kitakyushu, Japan.
Pediatric Dentistry, Fukuoka Children's Hospital, Fukuoka, Japan.
J Dent Sci. 2025 Jan;20(1):248-253. doi: 10.1016/j.jds.2024.07.035. Epub 2024 Aug 10.
BACKGROUND/PURPOSE: Complications, such as postoperative pneumonia, can occur after pediatric cardiac surgery; however, studies on related changes in perioperative oral bacterial counts are scarce. Herein, we investigated the changes in oral bacterial counts before and after surgery in infants who underwent cardiac surgery, as well as after oral care using an antiseptic mouthwash.
A total of 102 infants who underwent congenital heart disease surgery were enrolled in this study. Preoperative oral care was provided using water and a sponge brush. Bacterial cultures were used to determine salivary bacterial counts before and after oral care. Postoperatively, the infants were randomized into a water group (WA group), benzethonium chloride mouthwash group (BZ group), or povidone-iodine mouthwash group (PV-I group), and their salivary bacterial counts, before and after oral care, were measured.
The preoperative salivary bacterial colony counts did not change after oral care; however, the postoperative bacterial counts were significantly lower, possibly because of the use of systemic antibiotics. Bacterial counts before and after oral care were not significantly different between the WA and BZ groups; however, bacterial counts were significantly decreased in the PV-I group after oral care.
Overall, the results of this study show that systemic administration of antibiotics reduces postoperative salivary bacterial counts in infants undergoing cardiac surgery, and oral care with PV-I can further reduce bacterial counts.
背景/目的：小儿心脏手术后可能会出现并发症，如术后肺炎；然而，关于围手术期口腔细菌计数相关变化的研究却很少。在此，我们调查了接受心脏手术的婴儿手术前后口腔细菌计数的变化，以及使用抗菌漱口水进行口腔护理后的变化。
本研究共纳入102例接受先天性心脏病手术的婴儿。术前使用水和海绵刷进行口腔护理。通过细菌培养确定口腔护理前后的唾液细菌计数。术后，将婴儿随机分为水组（WA组）、苄索氯铵漱口水组（BZ组）或聚维酮碘漱口水组（PV-I组），并测量口腔护理前后的唾液细菌计数。
口腔护理后术前唾液细菌菌落计数未发生变化；然而，术后细菌计数显著降低，这可能是由于使用了全身性抗生素。WA组和BZ组口腔护理前后的细菌计数无显著差异；然而，PV-I组口腔护理后细菌计数显著降低。
总体而言，本研究结果表明，全身性使用抗生素可降低接受心脏手术婴儿术后的唾液细菌计数，使用聚维酮碘进行口腔护理可进一步降低细菌计数。
