title: Difficult intubation provokes bacteremia.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Traumatic manipulations during difficult laryngoscopy and endotracheal intubation could cause bacteremia. This finding may justify and guide prophylactic use of antibiotics.
authors.affiliation: Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece. ekonstan30@yahoo.com
authors.forename: Evangelos
authors.initials: E
authors.lastname: Konstantinou
authors.forename: Eriphili
authors.initials: E
authors.lastname: Argyra
authors.forename: Alexandra
authors.initials: A
authors.lastname: Avraamidou
authors.forename: Theofanis
authors.initials: T
authors.lastname: Fotis
authors.forename: Maria
authors.initials: M
authors.lastname: Tsakiri
authors.forename: Dionisios
authors.initials: D
authors.lastname: Voros
authors.forename: George
authors.initials: G
authors.lastname: Baltopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D001769:Blood / Q000382:microbiology; D003470:Culture Media; D004926:Escherichia coli / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy / Q000009:adverse effects; D008875:Middle Aged; D010462:Peptostreptococcus / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D003470:Culture Media