The occurrence of bacteraemia associated with the use of oral and nasopharyngeal airways.
In order to determine whether placement of oral or nasopharyngeal airways during anaesthesia induces a significant bacteraemia, 36 ASA grade 1 or 2 patients undergoing body surface surgery, in whom it was anticipated that spontaneous respiration would be maintained, were randomly allocated to one of two groups. One group was given oral airways and the other, nasopharyngeal. A series of blood samples, which were taken before and after airway insertion, were cultured aerobically and anaerobically. Nasal and oral swabs were taken at the same time. Single isolates of Corynebacterium species and Acinetobacter species, together with two isolates of Staphylococcus epidermidis were grown from one culture bottle from 4 of the 36 patients studied. None of the oral or nasal swabs, or any of the subsequent or previous blood samples produced positive cultures for these organisms in these four patients. We believe that these results represent skin commensal contamination rather than bacteraemia in these four patients, and that bacteriological considerations should not influence decisions about the type of airway used during anaesthesia. However, prophylactic antibiotic therapy should still be provided for all high risk cases.
Ali
M T
MT
Department of Anaesthesia, St. Bartholomew's Hospital, West Smithfield, London.
Tremewen
D R
DR
Hay
A J
AJ
Wilkinson
D J
DJ
D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D016470:Bacteremia / Q000209:etiology*; D005260:Female; D006801:Humans; D007440:Intubation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009305:Nasopharynx; D009909:Oral Health