Microbial Profile of Tracheal Aspirates in Pediatric Tracheostomised Patients

Abstract

INTRODUCTION: Tracheostomy is a surgical procedure in which an opening is created between the external environment and trachea bypassing the upper airway. The presence of microorganisms colonizing the tracheobronchial airway of tracheostomised patients can potentially increase the risk of lower respiratory infections, failure of decannulation and poor surgical outcomes. The aim of the present research work was to study the microbiological profile of the tracheal aspirates and its antibiotic sensitivity in paediatric patients who had undergone tracheostomy.

MATERIALS & METHODS: The present study was conducted at the department of Otorhinolaryngology at a paediatric tertiary care hospital between August 2023-2024. 59 paediatric tracheostomised patients aged 1 day-18 years were included in the study. Tracheal aspirate obtained during regular tube changes was tested for the presence of microorganisms and their antibiotic sensitivity.

RESULTS: Of the 68 patients who underwent tracheostomy tube changes, 59 were included in the present study. 91.53% of the study population tested positive for microbial growth in the tracheal aspirate. Pseudomonas aeruginosa (69.49%) was the most common organism isolated. 10.17% showed methicillin resistant Staphylococcus aureus (MRSA) and were positive for airway granulations.

CONCLUSION: Despite the numerous benefits of tracheostomy, the presence of tracheostomy tube in the airway acts as a contributing factor for the colonization of pathogenic bacteria. Presence of biofilm forming microorganisms in the airway can increase the risk of lower respiratory infections, decreased potential for decannulation and increased risk of airway surgical failure.