Bacteremia during dacryocystorhinostomy: results of intra-operative blood cultures
Bacteremia during dacryocystorhinostomy: results of intra-operative blood cultures
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DOI：
10.1186/s12348-014-0027-7
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发表时间：
2014-01-01
影响因子：
2.9
通讯作者：
Naik, Milind N.
中科院分区：
文献类型：
--
作者：
Ali, Mohammad Javed;Ayyar, Anuradha;Naik, Milind N.
背景：本研究的目的是评估泪囊鼻腔造口术（DCR）中菌血症的发生率，并评估是否需要术后预防。对2013 - 2014年1年间50例患者连续行52例泪囊鼻腔造口术的前瞻性介入研究。在两个不同的时间点：鼻粘膜形成和泪囊皮瓣的形成，在严格的无菌条件下抽取血液。将血液接种到两个血培养瓶中：双培养基和哥伦比亚肉汤。取血后，所有患者术中均给予单剂量头孢菌素抗生素。原发性获得性鼻泪管阻塞（PANDO）的清洁病例（22%,11/50）术后无任何囊腔排出，未给予术后常规预防治疗，其余患者给予口服抗生素治疗5天。结果：患者平均年龄41岁（范围4 ~ 61岁）。最常见的诊断（70%,35/50）是原发性获得性鼻泪管阻塞。急性泪囊炎发生率为12%（6/50）。65%（34/52）的病例行外部DCR， 35%（18/52）的病例行内窥镜DCR。所有的血培养在培养基和亚代培养中均呈阴性。22%（11/50）未接受术后抗生素预防。没有患者出现任何伤口感染的迹象。解剖和功能成功率达98%。结论：本研究未发现泪囊鼻腔造口术中出现任何术中菌血症，且无论术后预防措施如何，均无伤口感染。
Background: The aims of the study are to assess the prevalence of bacteremia during dacryocystorhinostomy (DCR) and to assess whether there is a need for post-operative prophylaxis. Prospective interventional study of 52 consecutive dacryocystorhinostomy performed in 50 patients over a period of 1 year from 2013 to 2014. Blood was drawn under strict aseptic conditions during two separate time points: fashioning of the nasal mucosal and creation of lacrimal sac flaps. The blood was inoculated into two blood culture bottles: the dual media as well as Columbia broth. Following withdrawal of blood, all patients received an intraoperative single dose of a cephalosporin antibiotic. Clean cases of primary acquired nasolacrimal duct obstructions (PANDO) without any sac discharge upon marsupialization (22%, 11/50) were not prescribed routine post-operative prophylaxis, whereas the remaining were prescribed oral antibiotics for 5 days.Results: The mean age of patients was 41 years (range, 4-61 years). The most common diagnosis (70%, 35/50) was primary acquired nasolacrimal duct obstruction. Acute dacryocystitis was noted in 12% (6/50). External DCR was performed in 65% (34/52) and endoscopic DCR in 35% (18/52) of the cases. All the blood cultures were uniformly negative both in terms of abnormal physical changes in media as well subcultures; 22% (11/50) did not receive post-operative antibiotic prophylaxis. None of the patients developed any signs of wound infections. The anatomical and functional success rate was achieved in 98%.Conclusions: This study did not find any intraoperative bacteremia during dacryocystorhinostomy and that none had wound infection irrespective of post-operative prophylaxis.