The aim of the study was to determine the prevalence and bacteriology of
bacteremia associated with
cleft lip and palate (CLP) surgery. Three venous blood samples were obtained from 90 eligible subjects who presented for CLP surgery: before
surgical incision, 1 minute after placement of the last
suture, and 15 minutes thereafter. The samples were injected into an Oxoid Signal blood culture and transported to the laboratory for gram-positive/negative and aerobic/anaerobic bacteria analysis. Prevalence of
bacteremia associated with cleft surgery was 38.1%. Prevalence rates of
bacteremia in
cleft lip surgery,
cleft palate surgery, and
alveoloplasty were 40.9%, 33.3%, and 50%, respectively. There was no significant difference in prevalence rate of positive blood culture in
cleft lip surgery,
cleft palate surgery, and
alveoloplasty (P = 0.69). Positive blood culture was detected most frequently (47%) 1 minute after placement of the last
suture. Of the 23 subjects who had positive blood culture at 1 minute,
bacteremia persisted in 8 (35%) of them after 15 minutes. The most common bacteria isolated were
coagulase-negative staphylococcus, Acinetobacter lwoffii, and
coagulase-positive Staphylococcus aureus. Sex and age of the subjects, duration of surgery, blood loss, and type of cleft surgery were not significantly associated with positive blood culture.
Bacteremia associated with CLP surgery is polymicrobial and persisted for at least 15 minutes after surgery in 35% of cases. This may reinforce the need for prophylactic
antibiotics to protect at-risk patients from developing
focal infection of the heart by oral flora.