Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2018, Vol. 40 ›› Issue (3): 356-359.doi: 10.3881/j.issn.1000-503X.2018.03.010

• Original Articles • Previous Articles     Next Articles

Influence of Nasal Disinfection on Nasal Bacterial Colonization through the Transsphenoidal Approach

LIU Xiaohai1,JIN Yu1,GUO Xiaopeng1,FENG Ming1,BAO Xinjie1,DENG Kan1,YAO Yong1,LIAN Wei1,YANG Qiwen2,WANG Renzhi1,XING Bing1()   

  1. 1 Department of Neurosurgery, ,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2 Department of Laboratory Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2017-11-21 Online:2018-06-30 Published:2018-07-05
  • Supported by:
    Supported by the Peking Union Medical College Young Doctors’ Research Foundation and the Innovative Training Program for College Students(2017zlgc0605)

Abstract:

Objective To explore the influence of the iodine disinfection on nasal bacterial colonization through the transsphenoidal approach.Methods Totally 133 pituitary adenoma patients who underwent transsphenoidal surgery in our department from January to August 2017 were enrolled in this study. Before disinfection,pharyngeal swabs of inferior turbinate root secretions were taken for bacterial culture. After iodine disinfection,pharyngeal swabs were taken again at the same site. Changes in the nasal bacterial spectrum before and after disinfection were compared. Patients were followed up for three months after the surgery,during which any intracranial infection/bacteraemia was recorded,and its correlation with nasal bacteria colonization was analyzed.Results Nasal bacterial colonization was detected in 45 (33.8%) of 133 patients before iodine disinfection and in only 6 cases (4.5%) after iodine disinfection (χ 2=34.5,P=0.000). Thus,iodine disinfection eliminated 86.7%(39/45) of the colonized bacteria. The most common nasal bacterium was Staphylococcus aureus (24.4%,11/45),followed by Klebsiella pneumoniae (24.4%,11/45),and Staphylococcus epidermidis (13.3%,6/45). One patient had high fever and chills 2 days after surgery,but blood culture and cerebrospinal fluid culture showed negative results. After the administration of third-generation cephalosporins,the symptoms disappeared after two days.Conclusions There are colonized bacteria in nasal cavity. Iodine disinfection of nasal cavity can effectively clear most of the nasal bacteria. The possibility of intracranial infection/bacteremia after transsphenoidal approach is low.

Key words: transsphenoidal surgery, iodophor disinfection, nasal bacteria, bacteremia, intracranial infection

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