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Bacterial Colonization of the Lower Airways in Children With Esophageal Atresia

Eleonora Sofie van Tuyll van Serooskerken1, Rauand Duhoky1, Johannes W Verweij1,2

  • 1From the Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.

The Pediatric Infectious Disease Journal
|May 12, 2023
PubMed

Insights

Patients with esophageal atresia (EA) frequently have lower airway bacterial colonization (LABC), increasing the risk of severe respiratory infections. This study identifies common pathogens and risk factors associated with LABC in EA patients.

Area of Science:

  • Pediatric Surgery
  • Pulmonology
  • Infectious Diseases

Background:

  • Esophageal atresia (EA) often co-occurs with tracheomalacia (TM), impairing airway secretion clearance.
  • Ineffective airway clearance in EA patients can lead to lower airway bacterial colonization (LABC).
  • LABC is a potential cause of recurrent respiratory tract infections (RTIs) in individuals with EA.

Purpose of the Study:

  • To determine the prevalence of LABC in patients with EA.
  • To identify specific bacterial pathogens responsible for LABC in this population.
  • To explore associations between LABC and clinical factors in EA patients.

Main Methods:

  • A 5-year retrospective single-site cohort study.
  • Inclusion of EA patients undergoing intraoperative bronchoalveolar lavage (BAL).
  • LABC defined as >10 cfu/mL in BAL samples.

Main Results:

  • 57% of 56 evaluated EA patients showed LABC in at least one BAL sample.
  • Haemophilus influenzae (14%) and Staphylococcus aureus (16%) were the most common pathogens.
  • LABC was significantly associated with a higher number of RTIs (P=0.008) and recurrent fistula (P=0.04).

Conclusions:

  • EA patients exhibit a high prevalence of LABC.
  • LABC may be a primary driver of severe and recurrent respiratory complications in EA.
  • This finding highlights the importance of monitoring and managing LABC in EA management.
Abstract

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