Association Between Oral Microbiome in Children Undergoing Palatoplasty and Surgical Site Infection.

Abstract

ObjectiveTo determine the prevalent preoperative oral microbial flora in children undergoing palatoplasty and its association with surgical site infection (SSI).DesignProspective observational longitudinal study.SettingSingle-center study done at tertiary care institute of Craniofacial surgery during the period of October 2022 to April 2024.ParticipantsThe study participants were the children posted for palatoplasty in our institution. Children with other major anomalies, immunodeficiency, and systemic illness were excluded. A total of 30 consecutive samples were enrolled during the study period, and all were followed up to finish the study.InterventionsSubgingival plaque samples were taken preoperatively and one postoperatively in the event of SSI and culture sensitivity analysis was done to detect pathogenic micro-organisms.Outcome measuresRisk analysis done for the baseline characteristics.ResultsMost common pathogenic organism seen preoperatively was Streptococcus mitis (34.8%) followed by Klebsiella pneumoniae (26%) and Staphylococcus aureus (26%). Bottle-fed children and those with preoperative infections had an adjusted odds ratio of 36.56 (P = .004) and 5.71 (P = .05), respectively, for colonization by pathogenic flora. The incidence of SSI was 25.8% in the population, with K pneumoniae as the most common cause (75%). The children who were underweight and had past hospital admission had an odds ratio of 16.67 (P = .002) and 10.2 (P = .009) for developing SSI.ConclusionWe conclude that bottle feeding and past infections play a role in colonization by pathogenic flora. Klebsiella pneumoniae is the common organism causing SSI, and nutrition status plays a role in development of SSI.