Bacteraemia following single-stage percutaneous dilatational tracheostomy

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pulmonology

Background:

• Percutaneous dilatational tracheostomy (PDT) is a common bedside procedure in critically ill adults, largely replacing surgical tracheostomy.
• Potential complications include hemorrhage, infection, and bacteremia, though the latter is not extensively studied.
• Prophylactic antibiotics are not standard practice for PDT.

Purpose of the Study:

• To investigate the incidence of bacteremia following percutaneous dilatational tracheostomy (PDT).
• To assess the impact of antibiotic therapy on bacteremia rates after PDT.

Main Methods:

• Prospective observational study conducted in an adult intensive care unit.
• Collected peripheral venous blood cultures immediately before and after PDT in 118 consecutive patients.
• Monitored surveillance cultures for respiratory pathogens via bronchoalveolar lavage.

Main Results:

• Bacteremia occurred in 5.3% of patients post-PDT.
• Patients not receiving antibiotics had a higher incidence of bacteremia (9.2%) compared to those on antibiotics.
• Unexpected bacteremia was identified in 5 patients, with 2 on antibiotic therapy.

Conclusions:

• The incidence of bacteremia after PDT is comparable to other airway manipulations.
• Routine antibiotic prophylaxis for PDT is likely not necessary.
• Further research may refine antibiotic use in specific patient populations undergoing PDT.