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Pediatric tracheostomy: epidemiology and characterization of tracheal secretion - a literature review
Caroline Espíndola de Barros1, Juliana Afonso de Almeida1, Mariana Helena E Silva2
1. Programa Ciências da Saúde da Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, GO, Brasil.
Insights
Tracheostomized children frequently develop respiratory infections due to bacterial colonization and biofilm formation. Pseudomonas aeruginosa is the most common pathogen, followed by Staphylococcus aureus, highlighting the need for targeted infection control strategies.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Microbiology
Background:
- Tracheostomized children are at high risk for respiratory infections due to bacterial colonization and biofilm formation on the tracheal tube.
- Biofilms protect bacteria from antibiotics, complicating treatment and increasing infection severity.
Purpose of the Study:
- To conduct a 10-year literature review on bacterial infections in pediatric tracheostomized patients.
- To identify and characterize the most frequently isolated bacteria from tracheal secretions in this population.
Main Methods:
- A systematic literature search was performed across Lilacs, SciELO, Medline Plus, and PubMed databases.
- Keywords included 'tracheostomy,' 'tracheotomy,' 'infections,' 'children,' and 'bacterial'.
Main Results:
- 19 studies involving 4,472 pediatric patients were reviewed.
- Pseudomonas aeruginosa was the predominant bacterium, found in a significant percentage of cases.
- Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, and Stenotrophomonas maltophilia were also frequently isolated.
Conclusions:
- Bacterial infections and biofilm formation are significant complications in tracheostomized children.
- Pseudomonas aeruginosa and Staphylococcus aureus are the most prevalent pathogens, necessitating focused preventative and therapeutic approaches.
Introduction:
Despite the benefits, tracheostomized children are susceptible to respiratory infections, since the tube is located in a strategic region where there is colonization by several bacteria and biofilm formation. Biofilm is formed when the bacteria adhere strongly to the surfaces of the tubes, providing protection against various types of aggression, such as antibiotic treatment.
Objective:
To carry out a literature review of the last ten years on tracheostomized pediatric patients, in order to characterize the bacteria isolated in children's tracheal secretions, and verify which ones are the most frequent.
Methods:
Two authors searched the Lilacs, SciELO, Medline Plus, and PubMed databases. The MeSH terms used were: 'tracheostomy' and 'tracheotomy' associated with 'infections', 'children', 'child', and 'bacterial' as qualifiers.
Results:
Of the 512 studies on the subject, 19 were selected for review. The total number of children evaluated in the studies was 4,472, with a mean age of 7.5 years. As for the bacteria found in the secretions of tracheostomized children, 12 species of bacteria were more frequent, P. aeruginosa was the predominant bacterium, followed by S. aureus (63.1%), Klebsiella pneumoniae (57.8%), Streptococcus pneumoniae (47.3%), and Stenotrophomonas maltophilia (47.3%).
Conclusion:
One of the main complications treated in tracheostomized patients were infections, since the respiratory system is colonized by several bacteria that can cause serious infections, which are associated with the formation of biofilms. The predominant bacterium in most of the studies was P. aeruginosa, and the second species commonly reported was S. aureus.
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