J Korean Soc Laryngol Phoniatr Logoped.  2021 Apr;32(1):29-34. 10.22469/jkslp.2021.32.1.29.

Respiratory Tract Bacterial Colonization in Long-Term Tracheostomized Pediatric Patients: Comparison between Sites and Two Different Timepoints

• Han SH
• Kim YS
• Kwon SK

• KMID: 2515640
• DOI: http://doi.org/10.22469/jkslp.2021.32.1.29

Abstract

Background and Objectives
Tracheostomy lead to persistent bacterial colonization of the respiratory tract. Surgical site infection and restenosis by the pathogenic bacteria is the most fatal complication after open airway surgery. The aim of this study is to describe the culture results of larynx and tracheostoma in patients with tracheostomy and the preoperative, intraoperative culture results in patients underwent open airway surgery. Materials and Method A retrospective review was performed on 18 patients who underwent culture between 2017 and 2019.
Results
Pseudomonas or antibiotic resistance bacteria were identified in 11 patients out of 18 patients (61.1%); Ceftriaxone-resistant Streptococcus (38.9%), Pseudomonas (33.3%), Methicillin- resistant Staphylococcus aureus (16.7%), extended-spectrum β-lactamases (ESBL) producing Klebsiella pneumoniae (11.1%). Among 18 patients, 6 patients showed the different culture result between larynx and tracheostoma. In 4 out of 10 patients who underwent open airway surgery, the bacteria were not identified before surgery, but the bacteria were isolated in the intraoperative culture. In one patient, the bacteria detected intraoperatively were different from those detected before surgery.
Conclusion
Preoperative respiratory tract culture and usage of perioperative antibiotics according to the culture are necessary. It is crucial to verify the bacterial culture in both tracheostoma and larynx. And it should be performed immediately before open airway surgery.

Keyword

Subglottic stenosis; Tracheostomy; Bacterial culture test; Antimicrobial susceptibility test; Prophylactic antibiotics; 성문하협착, 기관절개술, 균 배양검사, 항생제 감수성, 예방적 항생제