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

장기간 기관절개공을 유지한 소아 환자들에서의 기도 세균집락에 관한 연구: 균동정 부위와 시차 간의 차이 비교

  • Han, Seung Hoon (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • Kim, Young Seok (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • Kwon, Seong Keun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital)
  • 한승훈 (서울대학교병원 이비인후과) ;
  • 김영석 (서울대학교병원 이비인후과) ;
  • 권성근 (서울대학교병원 이비인후과)
  • Received : 2020.12.15
  • Accepted : 2021.01.28
  • Published : 2021.04.30

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.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2020R1A4A4079931).

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