Preoperative microbiological screening in pediatric assessment of skeletal dysplasias cases before planned orthopedic surgery

Abstract

AIM: 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. METHODS: The study was conducted on children with 29 different clinical diagnoses with preoperatively measured hemoglobin, platelets, blood glucose, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, serum creatinine, total protein, and fibrinogen. The performed pre-operative 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. RESULTS: 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, Staphylococcus aureus was identified in 39.3% (as methicillin-susceptible S. aureus) and in 3.3% of the children (as methicillin-resistant S. aureus [MRSA]). The other predominant Gram-positive bacteria were Streptococcus pneumoniae, Streptococcus pyogenes, Moraxella catarrhalis, and Candida 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. CONCLUSION: The presented microbiological screening protocol detects staphylococcal carriers, provides a solution for eradication of MRSA, oral pre-operative treatment of S. pyogenes, and personalized pre-operative antibacterial prophylaxis consistent with antibacterial susceptibility.