Bacteremia as a Complication of Nasotracheal Intubation

Dinner, Miles; Tjeuw, Michael; Artusio, Joseph F.

doi:10.1213/00000539-198705000-00017

Cited by 47 publications

(24 citation statements)

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“…Some authors have reported negative cultures after nasal intubation, 21,22 and others have found a varying incidence (5.5% to 17%) from nasotracheal intubation in all age groups. 23,24 The current AHA guidelines do not address the issue of intubation and risk for IE.…”

Section: Actinomyces Odontolyticus Propionibacterium Acnes S Mutansmentioning

confidence: 99%

Impact of Amoxicillin Prophylaxis on the Incidence, Nature, and Duration of Bacteremia in Children After Intubation and Dental Procedures

et al. 2004

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Background-Controversy exists about the impact of prophylactic antibiotics on bacteremia after invasive dental procedures. The purpose of this double-blind, randomized, placebo-controlled study was to determine the impact of amoxicillin prophylaxis on the incidence, nature, and duration of bacteremia from nasotracheal intubation and dental procedures in children. Methods and Results-Children were randomly assigned before surgery to the American Heart Association (AHA)-recommended dose of amoxicillin or to a placebo. Aerobic and anaerobic blood cultures were drawn at 8 specific time points after intubation, dental restorative and cleaning procedures, and before, during, and after dental extraction(s), to include blood drawings up to 45 minutes after the last extraction. Aerobic and anaerobic blood culture results were used to determine the incidence, nature, and duration of bacteremia from these procedures. For the 100 children enrolled (mean age, 3.5 years), the overall incidence of positive blood cultures, defined as at least 1 positive culture of the 8, was significantly higher in the placebo (84%) than the amoxicillin group (33%) (PϽ0.0001). Bacteremia occurrence rates after intubation and after dental restorations and cleaning were 18% and 20% in the placebo group and 4% and 6% in the amoxicillin group (Pϭ0.05 and Pϭ0.07, respectively). At 1.5 minutes after the initiation of dental extractions, bacteremia occurred in 76% of the placebo group versus 15% of the amoxicillin group (PϽ0.001). The majority of the 152 positive cultures and of the 29 different bacteria identified were Gram-positive cocci. Bacteremia persisted longer in the placebo group. Conclusions-Bacteremia from these procedures occurs more often, from a wider variety of bacterial species, and for a longer duration after dental extractions than previously reported in any age group. Amoxicillin has a significant impact on the incidence, nature, and duration of bacteremia after nasal intubation, dental restorative and cleaning procedures, and dental extractions.

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Section: Actinomyces Odontolyticus Propionibacterium Acnes S Mutansmentioning

confidence: 99%

Impact of Amoxicillin Prophylaxis on the Incidence, Nature, and Duration of Bacteremia in Children After Intubation and Dental Procedures

et al. 2004

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“…Dental procedures may not be associated with the development of PJIs . However, many studies demonstrate that there is increased bacteremia after dental procedures, as the incidence of bacteremia from oral procedures ranged from 5% to 65% . Thus, we conclude that using antibiotic prophylaxis for dental procedures after TJA to decrease the risk of bacteremia following dental procedures is justifiable to decrease the risk of sustaining a PJI within the first 2 years after surgery.…”

Section: Question 4: Should a Patient With Tja Be Given Routine Dentamentioning

confidence: 77%

Prevention of Late PJI

2014

Journal Orthopaedic Research

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“…The incidence of bacteremia in patients undergoing upper airway surgery and instrumentation has been documented to vary greatly depending on the procedure. For example, the incidence of bacteremia during tonsillectomy approximates 35%, 7 the incidence during nasotracheal intubation approximates 5%, 8 and the incidence following myringotomy with or without tube placement is virtually zero. 9 Studies assessing flexible bronchoscopy have found little or no incidence of associated bacteremia.…”

Section: Methodsmentioning

confidence: 99%