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Risk factors for bacteremia during and after adenoidectomy and/or adenotonsillectomy

Susanna Esposito1, Paola Marchisio, Pasquale Capaccio

  • 1Institute of Pediatrics, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.

The Journal of Infection
|January 10, 2009
PubMed

Insights

Bacteremia is more common after adenotonsillectomy than adenoidectomy, especially in children with recurrent acute otitis media or recurrent tonsillopharyngitis. Nasopharyngeal bacteria often correlate with bloodstream infections during these procedures.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Infectious Disease

Background:

  • Adenoidectomy and adenotonsillectomy are common pediatric procedures.
  • Bacteremia, the presence of bacteria in the bloodstream, can occur during these surgeries.
  • Understanding the incidence and risk factors for bacteremia is crucial for patient safety.

Purpose of the Study:

  • To determine the incidence and persistence of bacteremia in children undergoing adenoidectomy or adenotonsillectomy.
  • To investigate the association between the type of surgery and bacteremia.
  • To explore the link between pre-existing conditions and bacteremia.

Main Methods:

  • 130 children were enrolled, undergoing adenoidectomy (for recurrent acute otitis media or persistent otitis media with effusion) or adenotonsillectomy (for obstructive sleep apnea syndrome or recurrent tonsillopharyngitis).
  • Bacterial cultures were performed on nasopharyngeal aspirates, surgical tissue, and blood samples taken pre- and post-operatively.
  • Statistical analysis was used to compare bacteremia rates across different surgical groups and indications.

Main Results:

  • Adenotonsillectomy was associated with a significantly higher incidence of positive blood cultures compared to adenoidectomy.
  • Children with recurrent acute otitis media or recurrent tonsillopharyngitis had higher rates of bacteremia than those with persistent otitis media with effusion or obstructive sleep apnea syndrome.
  • Nasopharyngeal colonization significantly increased the likelihood of positive blood cultures, with matching bacteria found in 80% of cases.

Conclusions:

  • Bacteremia is significantly more frequent following adenotonsillectomy than adenoidectomy.
  • Patients with a history of recurrent acute otitis media or recurrent tonsillopharyngitis are at higher risk for bacteremia during these procedures.
  • Nasopharyngeal and tonsillar/adenoidal bacterial presence is a strong indicator for bacteremia during surgery.
Abstract

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