Risk of Bacteremia After Endotracheal Intubation for General Anesthesia

Ma, Gerber; As, Gastanaduy; Jj, Buckley; El, Kaplan

doi:10.1097/00007611-198011000-00018

Cited by 16 publications

(12 citation statements)

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“…In prior studies [16,17], the samples were taken 5 min after intubation. In studies where the cultures were drawn 10 min after intubation, Gerber et al [18] and Goldstein et al [2] reported a higher incidence of bacteremia, but still less than that we found in difficult intubations.…”

Section: Discussioncontrasting

confidence: 70%

“…The incidence of bacteremia after endotracheal intubation has been examined in earlier studies [16][17][18] and was reported to be 0-5.3%. In a series of 62 patients, Goldstein et al found an incidence of bacteremia of 3.2% [2].…”

Section: Discussionmentioning

confidence: 99%

“…In a series of 62 patients, Goldstein et al found an incidence of bacteremia of 3.2% [2]. The incidence of bacteremia in other procedures such as nasotracheal intubation is higher [18,19]. The incidence of bacteremia in our study (12%) cannot be attributed to contamination during the procedure, as all equipment was sterilized, and all staff members used sterile gloves in every intervention, including IV cannulation, endotracheal intubation, and blood aspiration for bacterial culture or any other purpose.…”

Section: Discussionmentioning

confidence: 99%

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Difficult Intubation Provokes Bacteremia

Konstantinou

Αrgyra

Avraamidou

et al. 2008

Surgical Infections

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Purpose: To evaluate the prevalence of bacteremia after mask ventilation, laryngoscopy, and endotracheal intubation before induction of general anesthesia and to discover any correlation between traumatic manipulations and bacteremia. The specific bacteria responsible, knowledge of which may guide the prophylactic use of antibiotics, also were investigated. Methods: Fifty patients were enrolled. Three 10-mL blood samples were collected from a peripheral vein 10 min before induction of anesthesia, 10 min after mask ventilation, and 10 min after intubation. All samples were placed in aerobic and anaerobic bottles for culture and bacterial identification. Results: Cultures received 10 min after intubation were positive in 12% of patients. The following strains were isolated: Escherichia coli in two cases, Staphylococcus aureus in three cases, and Peptostreptococcus anaerobius in one case. A strong positive correlation was found between difficult intubation and bacteremia. No correlation between bacteremia and easy intubation or between bacteremia and face mask ventilation was identified. Conclusion: Traumatic manipulations during difficult laryngoscopy and endotracheal intubation could cause bacteremia. This finding may justify and guide prophylactic use of antibiotics. 521

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Difficult Intubation Provokes Bacteremia

Konstantinou

Αrgyra

Avraamidou

et al. 2008

Surgical Infections

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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: 97%

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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“…However, this Society also recommended the administration of oral amoxicillin for ‘at‐risk’ dental procedures, regardless of whether this treatment was performed under local or general anaesthesia [3]. This absence of a consensus between the different expert committees regarding the significance of tracheal intubation as a risk factor for bacterial endocarditis may be explained by the different incidences of post‐intubation bacteraemia reported in the literature, which vary between 0% and 33% [4–16] (Table 1). However, very few authors have analysed the influence of the route of tracheal intubation in the production of bacteraemia.…”

Section: Major Studies Of the Incidence Of Bacteraemia After Tracheamentioning

confidence: 99%

The incidence of bacteraemia associated with tracheal intubation

et al. 2008

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Summary Expert committees on bacterial endocarditis prophylaxis have provided differing opinions on whether tracheal intubation is an ‘at‐risk’ manipulation. We studied the incidence of bacteraemia after orotracheal and nasotracheal intubation. The study group comprised 110 patients who underwent surgery under general anaesthesia. Venous blood samples were collected from each patient at baseline and 30 s after intubation. Samples were processed with conventional microbiological techniques. Bacteraemia after tracheal intubation was detected in 13 patients (11.8%); six after orotracheal intubation and seven after nasotracheal intubation. Staphylococci and streptococci were the most commonly isolated bacterial species. Seven isolates (54%) were resistant to oxacillin. The incidence of bacteraemia was similar after orotracheal (12.0%) and nasotracheal intubation (11.7%). The recommendation for bacterial endocarditis prophylaxis with flucloxacillin when performing nasotracheal intubation, as put forward by the British Society for Antimicrobial Chemotherapy, needs further consideration.

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Risk of Bacteremia After Endotracheal Intubation for General Anesthesia

Cited by 16 publications

References 0 publications

Difficult Intubation Provokes Bacteremia

Difficult Intubation Provokes Bacteremia

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

The incidence of bacteraemia associated with tracheal intubation

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