The Bacteriology of Children before Primary Cleft Lip and Palate Surgery

Chuo, C.B.; Timmons, M.J.

doi:10.1597/03-108.1

Cited by 47 publications

(46 citation statements)

References 19 publications

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“…However, the researchers observed the species in only 2.3% of patients with cleft palate [32]. In contrast, Chuo and Timmons detected β -haemolytic streptococci in 11% of positive smears taken from patients with cleft lip and/or palate prior to surgical repair [18]. The presence of β -haemolytic streptococci in the oral cavity of subjects with CLP is related to postoperative complications, such as slow wound healing or the development of abscesses and fistulae [32].…”

Section: Discussionmentioning

confidence: 99%

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A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate

Machorowska-Pieniążęk

Mertas

Skucha-Nowak

et al. 2017

BioMed Research International

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Few reports have been published on the early microbiota in infants with various types of cleft palate. We assessed the formation of the oral microbiota in infants with complete cleft lip and palate (CLP n = 30) or cleft soft palate (CSP n = 25) in the neonatal period (T1 time) and again in the gum pad stage (T2 time). Culture swabs from the tongue, palate, and/or cleft margin at T1 and T2 were taken. We analysed the prevalence of the given bacterial species (the percentage) and the proportions in which the palate and tongue were colonised by each microorganism. At T1, Streptococcus mitis (S. mitis) were the most frequently detected in subjects with CLP or CSP (63% and 60%, resp.). A significantly higher frequency of methicillin-sensitive Staphylococcus aureus (S. aureus MSSA) was observed in CLP compared to the CSP group. At T2, significantly higher percentages of S. mitis, S. aureus MSSA, Staphylococcus epidermidis, and members of the Enterobacteriaceae family were noted in CLP infants compared to the CSP. S. mitis and Streptococcus sanguinis appeared with the greatest frequency on the tongue, whereas Streptococcus salivarius was predominant on the palate. The development of the microbiota in CLP subjects was characterised by a significant increase in the prevalence of pathogenic bacteria.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, changes in the amount and composition of oral microbiota have been reported in subjects with different types of cleft palate during deciduous or permanent dentition [17] and as the result of surgical or orthodontic treatment [18–20]. …”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate

Machorowska-Pieniążęk

Mertas

Skucha-Nowak

et al. 2017

BioMed Research International

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“…Because of the demand for a nearly perfect aesthetic outcome in the young cleft patient with little tolerance concerning infections that increase the risk of wound breakdown, palatal fistulas, poor speech or growth, and aesthetic results [26], a large number of patients might be receiving antibiotics when no clear indication exists for such prophylaxis [27]. Increasing evidence suggests that the application of nonindicated antibiotics exposes the young patients to the unnecessary risk of adverse effects and antibiotic-associated complications such as Clostridium difficile infection [28, 29].…”

Section: Discussionmentioning

confidence: 99%

Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

Kreutzer

Storck

Weitz

2014

BioMed Research International

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Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.

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“…The success of surgery depends on the surgeon and his/her technique and on the host factors of the baby, especially on the intra-oral organisms harboured by the baby. Certain intra-oral organisms are pathogenic and lead to wound breakdown, the formation of oro-nasal fistulas and to a lesser extent, poor aesthetic results 5 . This is particularly true in the case of a cleft of the soft palate.…”

mentioning

confidence: 99%

“…This is particularly true in the case of a cleft of the soft palate. The organisms that have been most often identified and associated with wound breakdown and failure of skin grafts, are Staphylococcus aureus and the b-haemolytic group of streptococci, and it is well-known that these organisms are also present in the upper aero-digestive passages 5,6 . Staph.…”

mentioning

confidence: 99%

Cleft soft palate reconstruction: prospective study on infection and antibiotics

Myburgh

Bütow

2009

International Journal of Oral and Maxillofacial Surgery

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Abstract. The aim of this prospective study was to identify possible pathogenic organisms associated with wound complications in the form of wound infections, wound breakdown and the formation of oro-nasal fistulas. The organisms' resistance profile to antibiotics was also evaluated. This prospective study consisted of the evaluation of the intra-oral microbiological profile of 100 babies with soft palate cleft deformities peri-operatively. A wide spectrum of pathogenic organisms from the upper aero-digestive track was isolated, as well as a group of organisms that originated from the colon/perineum. The latter organisms were mostly associated with postoperative complications. The antibiotic resistance profile showed a high resistance to commonly used antibiotics such as ampicillin, amoxycillin-clavulanic acid, and first-and second-generation cephalosporins. The resistance profile of the organisms needs to be reassessed and appropriate antibiotics must be used in combination with an antimicrobial mouth rinse.

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The Bacteriology of Children before Primary Cleft Lip and Palate Surgery

Abstract: 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.

Cited by 47 publications

References 19 publications

A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate

A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate

Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

Cleft soft palate reconstruction: prospective study on infection and antibiotics

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