Risk of bacteremia after endotracheal intubation for general anesthesia

Blood cultures were obtained before and after endotracheal intubation to assess the risk of bacteremia associated with this procedure and to evaluate the need for prophylactic antibiotics to prevent bacterial endocarditis in patients with structural heart disease requiring general anesthesia. Blood cultures were obtained immediately before intubation and two and ten minutes after intubation in 50 individuals without evidence of structural heart disease who required general anesthesia for elective surgery. Of 32 who had orotracheal intubation, only one demonstrated postintubation bacteremia; of 18 individuals who had nasotracheal intubation, none had evidence of bacteremia. These data suggest that in healthy individuals undergoing endotracheal intubation under direct vision the risk of bacteremia is quite small (about 2%).