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Updated: Sep 11, 2026

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Longitudinal dynamics of respiratory microbiome composition in infants after new tracheostomy placement
Rebecca Steuart1,2, Samantha N Atkinson3, Lucas R Hoffman4
1Section of Complex Care, Medical College of Wisconsin Department of Paediatrics, Milwaukee, Wisconsin, USA.
Objectives:
This prospective longitudinal study characterised respiratory microbiome dynamics following new tracheostomy placement among infants.
Setting:
A tertiary care paediatric hospital system in the United States.
Participants:
Fifteen infants ≤12 months of age contributed 84 tracheal aspirate samples collected from day 1 through 3-4 months post-placement.
Primary And Secondary Outcome Measures:
Bacterial composition, including abundance, from 16S rRNA gene sequencing; alpha and beta diversity measures over time.
Results:
16S rRNA gene sequencing revealed immediate and sustained bacterial community shifts. Staphylococcus abundance increased and alpha diversity decreased in the first 30 days post-tracheostomy (p<0.05) before returning to baseline. Beta diversity demonstrated compositional changes immediately and with ongoing divergence through 3-4 months. Time and clinical factors (prematurity, ventilation and neurologic impairment) were significantly associated with microbiome structure (p=0.001).
Conclusions:
This study provides novel evidence that new tracheostomy placement induces rapid and prolonged airway microbiome disruption in infants, highlighting a previously uncharacterised window of vulnerability with implications for respiratory health.
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