(HealthDay News) — For patients undergoing rhinoplasty, preoperative nasal culture can identify microbial flora that indicate risk of postoperative infection, according to research published online December 11 in JAMA Facial Plastic Surgery.

Donald B. Yoo, MD, from The Roxbury Institute in Beverly Hills, CA, and colleagues examined the microbial flora of patients undergoing septorhinoplasty. Medical records were received from 363 consecutive adult patients who underwent preoperative nasal swab testing and rhinoplasty or septorhinoplasty (47.9% underwent primary rhinoplasty; 52% underwent revision rhinoplasty).

The researchers found that 78.2% of patients had normal flora on preoperative nasal culture, while 10.8 and 0.28% had Staphylococcus aureus and methicillin-resistant S. aureus (MRSA), respectively. Fecal coliforms, including Escherichia coli, Enterobacter species, and Citrobacter species, were found in 7.4% of patients. There was no significant change in nasal flora or postoperative infection rate with age, sex, smoking, the use of oral contraceptives, or the presence of seasonal allergies. The overall infection rate was 3.0%, with 4.0 and 2.1% seen in primary septorhinoplasties and revision cases, respectively. Five cases of postoperative infections were due to coliforms (45.5%); S. aureus accounted for four cases (36.4%), including one of MRSA.

“Risk factors alone may not reliably predict the subset of patients in whom antibiotic prophylaxis is indicated,” the authors write.

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