Respiratory tract infections in children with tracheostomy
Background: Children with tracheostomy are at increased risk for respiratory tract infections, yet the risk involved in tracheostomy related infections is unclear. Methods: We conducted a retrospective review of the medical records of children who underwent tracheostomy between January 2002 and Dece...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-04-01
|
| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118218302846 |
| _version_ | 1818216227229663232 |
|---|---|
| author | Chiew-Yin Tan Nan-Chang Chiu Kuo-Sheng Lee Hsin Chi Fu-Yuan Huang Daniel Tsung-Ning Huang Lung Chang Yen-Hsin Kung Ching-Ying Huang |
| author_facet | Chiew-Yin Tan Nan-Chang Chiu Kuo-Sheng Lee Hsin Chi Fu-Yuan Huang Daniel Tsung-Ning Huang Lung Chang Yen-Hsin Kung Ching-Ying Huang |
| author_sort | Chiew-Yin Tan |
| collection | DOAJ |
| description | Background: Children with tracheostomy are at increased risk for respiratory tract infections, yet the risk involved in tracheostomy related infections is unclear. Methods: We conducted a retrospective review of the medical records of children who underwent tracheostomy between January 2002 and December 2016 at a teaching hospital in Taipei. Demographics, underlying disease, indication for tracheostomy, laboratory data and management, and long-term outcome data were collected. Infection episodes were grouped into definite, possible, non-bacterial pneumonia, and local infection groups. Results: Ninety patients were enrolled. Forty-two (46.7%) patients had infections that required hospitalization. Definite bacterial pneumonia accounted for 12 (8.5%) episodes, 113 episodes (80.1%) were possible bacterial pneumonia, 12 (8.5%) were non-bacterial pneumonia, and 4 (2.8%) were local infections. Patients with definite and possible bacterial pneumonia were found to have a longer hospital duration than patients with non-bacterial pneumonia (p=0.024), with mean hospitalization stays of 8.83±5.59 days and 5.67±2.55 days, respectively. The median duration from tracheostomy to bacterial pneumonia was 1.78 years (range, 0.04- 11.38) whereas for the non-bacterial pneumonia group it was 0.57 years (range, 0.04-6.61). Cerebral palsy (CP) (adjusted odds ratio [AOR] 3.65; 95% confidence interval [CI]: 1.11-11.99; p=0.033) and gastroesophageal reflux disease (GERD) (AOR 2.84; 95% CI: 1.09-7.38; p=0.033) were independently associated with respiratory tract infections in these children. Conclusion: In this study, CP and GERD were associated with infections in children with tracheostomy. Bacterial and non-bacterial pneumonia are difficult to differentiate clinically which may lead to unnecessary antibiotics use. Keywords: Children, Respiratory tract infections, Tracheostomy |
| first_indexed | 2024-12-12T06:48:37Z |
| format | Article |
| id | doaj.art-4c331ac3d0cb4fea8b926fa8c0c214e7 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-12T06:48:37Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-4c331ac3d0cb4fea8b926fa8c0c214e72022-12-22T00:34:06ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-04-01532315320Respiratory tract infections in children with tracheostomyChiew-Yin Tan0Nan-Chang Chiu1Kuo-Sheng Lee2Hsin Chi3Fu-Yuan Huang4Daniel Tsung-Ning Huang5Lung Chang6Yen-Hsin Kung7Ching-Ying Huang8Department of Pediatrics, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei, Taiwan; Corresponding author. 92, Sec. 2, Zhongshan N. Road, Taipei, 10449 Taiwan. Fax: +886225433642.Department of Otorhinolaryngology, MacKay Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei, TaiwanDepartment of Pediatrics, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatrics, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatrics, MacKay Memorial Hospital Tamshui, New Taipei, TaiwanDepartment of Pediatrics, MacKay Memorial Hospital Tamshui, New Taipei, TaiwanDepartment of Pediatrics, MacKay Children's Hospital, Taipei, TaiwanBackground: Children with tracheostomy are at increased risk for respiratory tract infections, yet the risk involved in tracheostomy related infections is unclear. Methods: We conducted a retrospective review of the medical records of children who underwent tracheostomy between January 2002 and December 2016 at a teaching hospital in Taipei. Demographics, underlying disease, indication for tracheostomy, laboratory data and management, and long-term outcome data were collected. Infection episodes were grouped into definite, possible, non-bacterial pneumonia, and local infection groups. Results: Ninety patients were enrolled. Forty-two (46.7%) patients had infections that required hospitalization. Definite bacterial pneumonia accounted for 12 (8.5%) episodes, 113 episodes (80.1%) were possible bacterial pneumonia, 12 (8.5%) were non-bacterial pneumonia, and 4 (2.8%) were local infections. Patients with definite and possible bacterial pneumonia were found to have a longer hospital duration than patients with non-bacterial pneumonia (p=0.024), with mean hospitalization stays of 8.83±5.59 days and 5.67±2.55 days, respectively. The median duration from tracheostomy to bacterial pneumonia was 1.78 years (range, 0.04- 11.38) whereas for the non-bacterial pneumonia group it was 0.57 years (range, 0.04-6.61). Cerebral palsy (CP) (adjusted odds ratio [AOR] 3.65; 95% confidence interval [CI]: 1.11-11.99; p=0.033) and gastroesophageal reflux disease (GERD) (AOR 2.84; 95% CI: 1.09-7.38; p=0.033) were independently associated with respiratory tract infections in these children. Conclusion: In this study, CP and GERD were associated with infections in children with tracheostomy. Bacterial and non-bacterial pneumonia are difficult to differentiate clinically which may lead to unnecessary antibiotics use. Keywords: Children, Respiratory tract infections, Tracheostomyhttp://www.sciencedirect.com/science/article/pii/S1684118218302846 |
| spellingShingle | Chiew-Yin Tan Nan-Chang Chiu Kuo-Sheng Lee Hsin Chi Fu-Yuan Huang Daniel Tsung-Ning Huang Lung Chang Yen-Hsin Kung Ching-Ying Huang Respiratory tract infections in children with tracheostomy Journal of Microbiology, Immunology and Infection |
| title | Respiratory tract infections in children with tracheostomy |
| title_full | Respiratory tract infections in children with tracheostomy |
| title_fullStr | Respiratory tract infections in children with tracheostomy |
| title_full_unstemmed | Respiratory tract infections in children with tracheostomy |
| title_short | Respiratory tract infections in children with tracheostomy |
| title_sort | respiratory tract infections in children with tracheostomy |
| url | http://www.sciencedirect.com/science/article/pii/S1684118218302846 |
| work_keys_str_mv | AT chiewyintan respiratorytractinfectionsinchildrenwithtracheostomy AT nanchangchiu respiratorytractinfectionsinchildrenwithtracheostomy AT kuoshenglee respiratorytractinfectionsinchildrenwithtracheostomy AT hsinchi respiratorytractinfectionsinchildrenwithtracheostomy AT fuyuanhuang respiratorytractinfectionsinchildrenwithtracheostomy AT danieltsungninghuang respiratorytractinfectionsinchildrenwithtracheostomy AT lungchang respiratorytractinfectionsinchildrenwithtracheostomy AT yenhsinkung respiratorytractinfectionsinchildrenwithtracheostomy AT chingyinghuang respiratorytractinfectionsinchildrenwithtracheostomy |