Related Experiment Video
Updated: Sep 24, 2026

Long Term Chronic Pseudomonas aeruginosa Airway Infection in Mice
Published on: March 17, 2014
Residence-Associated Differences in Airway Microbiology Among Tracheostomy-Dependent Children
Elia D Rackovsky1, Marley Cutrona2, Monica L Koncicki3
1Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, Division of Pediatric Critical Care, Harlem Hospital Center, New York, New York, USA.
Background:
Tracheostomy-dependent children (TDC) experience chronic airway instrumentation and frequent healthcare exposure, increasing their risk for colonization and infection with multidrug-resistant organisms (MDROs). Most TDC reside either in the community or in healthcare facilities, yet the impact of residential setting on airway microbiology in these children is not well characterized.
Methods:
We conducted a retrospective chart review of TDC ≤ 18 years admitted to an academic tertiary pediatric intensive care unit (PICU) between Jan 2017 and Dec 2022 who underwent tracheal aspirate cultures (TACs) within 72 h of admission. Airway microbiology and MDRO prevalence were compared between children presenting from healthcare facilities and the community. Multivariate mixed-effect logistic regression models evaluated factors associated with MDRO isolation, adjusting for age, number of admissions, and cuffed tracheostomy status.
Results:
Among 109 children (282 admissions; 207 community, 75 facility), facility residence was associated with higher odds of isolating any MDROs in bivariate analysis (OR 2.73 95% CI 1.19-6.25 p = 0.017). In multivariate analysis, ≥ 5 prior hospital admissions and cuffed tracheostomy remained independently associated with MDRO isolation. Although facility residence no longer retained statistical significance after adjustment, the adjusted odds ratio remained similar to the bivariate estimate.
Conclusions:
Healthcare facility residence is associated with increased MDRO isolation. Cumulative healthcare exposure and cuffed tracheostomy status may also be important risk factors for MDRO presence. Respiratory microbiology differs between facility- and community-based TDC. Awareness of local airway microbiologic patterns and cumulative healthcare exposure may improve interpretation of TACs and guide empiric antimicrobial therapy.
More Related Videos
Related Concept Videos
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Development of Human Microbiota
Development of the Oral Microbiota
Microbiota of the Respiratory Tract

