Risk factors for bacteremia during and after adenoidectomy and/or adenotonsillectomy

Objective: To evaluate the incidence and persistence of bacteremia in children undergoing adenoidectomy or adenotonsillectomy for different medical reasons. Methods: We enrolled 130 children scheduled for adenoidectomy because of recurrent acute otitis media (rAOM, 15) or persistent otitis media with effusion (pOME, 33), or for adenotonsillectomy because of obstructive sleep apnea syndrome (OSAS, 41) or recurrent tonsillopharyngitis (rTF, 41). Nasopharyngeal aspirates taken just before surgery, swabs of the ablated central adenoidal and tonsillar tissues, and blood samples taken within the first 30 s of beginning the operation and 20 min after its end were used for bacterial cultures. Results: The incidence of positive blood cultures after the beginning of the operation was significantly higher in the children who underwent adenotonsillectomy than in those who underwent adenoidectomy, and in those with rAOM or rTF than in those with pOME or OSAS. Children with nasopharyngeal colonisation were significantly more likely to have a positive blood culture than those without. Twenty of the 25 children with a positive blood culture (80.0%), had the same bacteria in their nasopharyngeal and adenoidal/tonsillar tissues. Conclusions: Our results show that bacteremia is significantly more frequently associated with adenotonsillectomy than with adenoidectomy, and significantly more frequent in patients with a history of rAOM or rTF.