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Oral Biofilm Analysis of Palatal Expanders by Fluorescence In-Situ Hybridization and Confocal Laser Scanning Microscopy
Published on: October 20, 2011
Association Between Oral Microbiome in Children Undergoing Palatoplasty and Surgical Site Infection
Suryakala Chandrasekaran1, Swathi Sunil Rao1, Vikram Shetty2
1Department of Pediatrics, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, India.
Insights
Bottle feeding and prior infections increase pathogenic oral flora in children undergoing palatoplasty. Klebsiella pneumoniae is a common cause of surgical site infections (SSI), with nutritional status impacting SSI development.
Area of Science:
- Oral microbiology
- Pediatric surgery
- Infectious disease
Background:
- Surgical site infection (SSI) is a significant concern in pediatric palatoplasty.
- Understanding preoperative oral microbial flora is crucial for preventing SSI.
Purpose of the Study:
- To identify prevalent preoperative oral microbial flora in children undergoing palatoplasty.
- To investigate the association between oral flora and SSI after palatoplasty.
Main Methods:
- Prospective observational study of 30 children undergoing palatoplasty.
- Subgingival plaque samples collected preoperatively and postoperatively (if SSI occurred).
- Culture sensitivity analysis performed to identify pathogenic microorganisms.
Main Results:
- Common preoperative flora included Streptococcus mitis (34.8%), Klebsiella pneumoniae (26%), and Staphylococcus aureus (26%).
- Bottle-fed children and those with preoperative infections had higher odds of pathogenic flora colonization.
- SSI incidence was 25.8%, with K. pneumoniae causing 75% of infections.
- Underweight children and those with prior hospital admissions had increased odds of developing SSI.
Conclusions:
- Bottle feeding and previous infections are linked to pathogenic oral flora colonization.
- Klebsiella pneumoniae is the primary pathogen causing SSI in this cohort.
- Nutritional status is a significant factor in the development of SSI post-palatoplasty.
Abstract:
ObjectiveTo determine the prevalent preoperative oral microbial flora in children undergoing palatoplasty and its association with surgical site infection (SSI).DesignProspective observational longitudinal study.SettingSingle-center study done at tertiary care institute of Craniofacial surgery during the period of October 2022 to April 2024.ParticipantsThe study participants were the children posted for palatoplasty in our institution. Children with other major anomalies, immunodeficiency, and systemic illness were excluded. A total of 30 consecutive samples were enrolled during the study period, and all were followed up to finish the study.InterventionsSubgingival plaque samples were taken preoperatively and one postoperatively in the event of SSI and culture sensitivity analysis was done to detect pathogenic micro-organisms.Outcome measuresRisk analysis done for the baseline characteristics.ResultsMost common pathogenic organism seen preoperatively was Streptococcus mitis (34.8%) followed by Klebsiella pneumoniae (26%) and Staphylococcus aureus (26%). Bottle-fed children and those with preoperative infections had an adjusted odds ratio of 36.56 (P = .004) and 5.71 (P = .05), respectively, for colonization by pathogenic flora. The incidence of SSI was 25.8% in the population, with K pneumoniae as the most common cause (75%). The children who were underweight and had past hospital admission had an odds ratio of 16.67 (P = .002) and 10.2 (P = .009) for developing SSI.ConclusionWe conclude that bottle feeding and past infections play a role in colonization by pathogenic flora. Klebsiella pneumoniae is the common organism causing SSI, and nutrition status plays a role in development of SSI.
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