Microbiology in children with tracheostomy and correlation with clinical outcomes

Introduction: There is increased risk of airway infection in children with tracheostomy. Data on clinical outcomes in children with tracheostomy is limited. Aims: To review the microbiology in our paediatric tracheostomy cohort and its correlation with clinical outcomes. Methods: Retrospective data collection of microbiology in our paediatrictracheostomy cohort over a five year period (2013-2018) including ventilated and non-ventilated patients and its correlation with clinical outcomes including frequency of hospitalisation, length of stay and intensive care admissions. Results: 37 children with tracheostomy were included in the study, 22 of which were tracheostomy ventilated. Pseudomonas aeruginosa was the most common organism isolated from tracheostomy cultures (isolated in 87% of patients) followed by Staphylococcus aureus (76%). In tracheostomy-ventilated patients, children who grew Haemophilusinfluenzae had the highest average number of hospital admissions (17.7 per patient over 5 years). In the non-ventilated patients, children who grew Stenotrophomonas maltophilia had the highest average number of hospital admissions (10.7 per patient over 5 years). In both ventilated and non-ventilated cohorts children with MRSA had the maximum number of intensive care admissions and highest mean length of hospital stay. Conclusions: Our data suggests there may be a correlation between microbiology in tracheostomy cultures and clinical outcomes. Microbiological surveillance is therefore important in children with a tracheostomy. Further studies would be useful to determine the relationship between microbiology and patient outcomes in children with tracheostomies.