BACTEREMIA DURING DIRECT LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION - ASTUDY USING A MULTIPLE CULTURE, LARGE-VOLUME TECHNIQUE

Bacteraemia secondary to orotracheal intubation has been reported to o ccur in 0-5.3% of patients, Bacteraemia detection is dependent upon se veral factors including the volume of blood per culture and the number of cultures. Prior studies used small volumes of blood and one or two cultures, and may therefore have underestimated the incidence of bact eraemia, Sixty-two adult patients who underwent direct laryngoscopy an d endotracheal intubation were studied. Baseline blood cultures were s terile in all patients. After intubation, four blood cultures were obt ained in ten minutes, with 10 ml being evenly divided between aerobic and anaerobic media, Two patients (3.2%) became bacteraemic. This is a lower incidence than occurs in association with other procedures for which The American Heart Association does not recommend administration of prophylactic antibiotics, Therefore, prophylactic antibiotics are not recommended prior to direct laryngoscopy. However, when a prophyla ctic antibiotic is administered prior to surgery, it would be best to administer the antibiotic prior to direct laryngoscopy and intubation.