title: The influence of direct rigid laryngoscopy on the nosocomial colonization and bacteremia.
abstract: OBJECTIVE
  Direct rigid laryngoscopy (DRL) is a relatively simple and well-tolerated procedure that can provide both diagnostic and therapeutic benefits. There are no data regarding the risk of acquiring bacteremia after DRL. The purpose of this prospective study was to assess the frequency of bacteremia and nosocomial colonization following DRL and to identify possible risk factors for the development of these complications.
  
  
  METHODS
  In this study, 55 consecutive patients with benign or malignant laryngeal pathologies undergoing DRL were included between January 2010 and January 2011. The patients have benign laryngeal lesions and suspicious malignancy. In appropriate circumstances of each patient before intubation and at postoperative 24 hours of throat swab, samples were taken in the transport medium of the patients who underwent planned DRL and underwent surgery. The samples were evaluated in our Microbiology Department. Blood cultures were performed using automated system at postoperative 5 and 24 hours. For each patient at preoperative and postoperative period, C-reactive protein levels in blood samples were measured. SPPS 16 package program was used for statistical analysis.
  
  
  RESULTS
  The distribution of sex was 45 males and 10 females with average age of 51.4 (between 23 and 99 years). Patients who had malignant lesions (n = 17) accounted for 30.9% of all patients. Preoperative Candida colonization was recovered from the cultures obtained from 9 oropharyngeal specimens (16.4%). Postoperative oropharyngeal nosocomial bacteria colonization was observed in 14 patients (25.5%). Nosocomial colonization was found related to malignancy (P = 0.014). C-reactive protein levels of patients before and after surgery were not statistically significant (P > 0.05). At postoperative 5 and 24 hours, blood cultures of all patients were negative. Postsurgical bacteremia was not observed.
  
  
  CONCLUSIONS
  Although there is no association between DRL and bacteremia, nosocomial colonization may be significant. Nosocomial colonization possesses a risk of development of infection especially in patients with malignancy.
authors.affiliation: From the Departments of *Otorhinolaryngology and †Infectious Diseases, ‡Microbiology, Mersin University, Mersin; and §Otorhinolaryngology Clinics, Osmaniye State Hospital, Osmaniye, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Vayisoğlu
authors.forename: Cengiz
authors.initials: C
authors.lastname: Özcan
authors.forename: Elif Sahin
authors.initials: ES
authors.lastname: Horasan
authors.forename: Candan
authors.initials: C
authors.lastname: Öztürk
authors.forename: Onur
authors.initials: O
authors.lastname: Ismi
authors.forename: Kemal
authors.initials: K
authors.lastname: Görür
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000635:transmission*; D001419:Bacteria; D002097:C-Reactive Protein / Q000032:analysis; D003428:Cross Infection / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000635:transmission*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009960:Oropharynx; D011877:Radionuclide Imaging; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis
chemical_list: D002097:C-Reactive Protein