Incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures

Abstract

Objective. The aim of this study was to determine the incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures. Methods.A total of 237 patients who underwent oral and maxillofacial surgery were included in this study. Blood samples were obtained for bacteriological examination immediately after the essential steps of the surgical procedure had been performed.Results. Bacteremia was detected in patients who underwent surgery for tumor, infection and trauma, and surgical reconstruction of jaw. In particular, decortication for osteomyelitis and tooth extraction resulted in a higher incidence of bacteremia compared with other surgical procedures. The incidence of bacteremia was not affected by oral hygiene, gingival inflammation, blood loss and duration of surgery. Furthermore, concerning tooth extraction, there was no statistical difference in the incidence of bacteremia with respect to the number of teeth extracted and the method of extraction.Extraction of teeth with odontogenic infection (periodontitis, periapical infection and pericoronitis) did however produce a significantly increased incidence of bacteremia compared with infection-free teeth (P<0.01).Viridans streptococci were the predominant group of bacteria isolated from the bacteremias. Conclusion.Oral and maxillofacial surgery involving trans-oral incision produces bacteremia, regardless of the extent and degree of surgical invasion. In particular, surgical procedure at infected sites is more likely to result in bacteremia compared with infection-free sites.

Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

“…Viridans group streptococci are the most frequently isolated bacteria in postextraction blood cultures (36,46), in agreement with the results obtained in previous studies (5). AMX prophylaxis showed a "selective effect" on Streptococcus spp., with a marked reduction in their prevalence in the positive postextraction blood cultures in our series, in which all the streptococci in the AMX group belonged to the S. mitis group.…”

Microbiology of Odontogenic Bacteremia: beyond Endocarditis

“…When surgical incisions were made to facilitate the extraction of teeth, particularly impacted third molars, with subsequent insertion of sutures, nearly 10% of individuals had a bacteremia following the removal of sutures, and the incidence was not reduced by the use of preoperative antiseptic rinses (16). Despite the fact that intubation is associated with bacteremia (93), no significant change in bacteremic incidence was observed when extractions were performed under general anesthesia (128). In addition, there is no apparent change in the incidence of bacteremia with increased numbers of teeth extracted or the use of mucoperiosteal elevators (103,111,133).…”

Prospective Comparison of Eubacterial PCR and Measurement of Procalcitonin Levels with Blood Culture for Diagnosing Septicemia in Intensive Care Unit Patients

“…Thus, these could be interpreted as truly positive results. Of the remaining four PCR-positive and procalcitonin-negative patients, two patients had undergone oropharyngeal and esophageal surgery and one had undergone coronary artery bypass grafting (CABG) on pump, procedures which are known to be associated with transient bacteremia (2,17,25). All 10 PCR-positive, blood culture-negative patients in group IV were on antibiotics, and the culture negativity in this group could be attributed to low and suppressed levels of bacteremia.…”