Preoperative Microbiological Screening in Pediatric Assessment of Skeletal Dysplasias Cases Before Planned Orthopedic Surgery

Abstract

We report the preoperative microbiological screening of gram positive bacteria as a promising diagnostic approach for precise pediatric assessment of children with skeletal dysplasias who have undergone planned orthopedic surgery within a period of 10 years. The study was conducted on children with 29 different clinical diagnoses with preoperatively measured haemoglobin, platelets, blood glucose, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, serum creatinine, total protein, and fibrinogen. The performed preoperative microbiological screening involved the examination of nasal and throat secretions aiming to detect carrier and/or colonization of potentially pathogenic microflora in these upper respiratory tract niches. The documented statistical data demonstrated that 50.8 % of the cases had normal microflora, however the rest 49.2 % of the patients had potentially pathogenic bacteria. Among them, S. aureus was identified in 39.3% (as methicillin-susceptible or MSSA) and in 3.3% of the children (as methicillin-resistant or MRSA). The other predominant gram-positive bacteria were S. pneumoniae, S. pyogenes, M. catarrhalis, and C. albicans in 1.6, 0.8, 2.4 and 2.4 %, respectively. The infected patients have been at significantly higher risk for staph infections after surgical procedures than those with normal microflora. The presented microbiological screening proves the need for obligatory preoperative eradication of MRSA from nose niche, oral preoperative treatment of Streptococcus pyogenes and personalized preoperative antibacterial prophylaxis.