Clinical Profile and Microbiological Spectrum of Tracheostomized Patients in a Tertiary Care Center: A Prospective...

Tracheostomy is commonly performed in critically ill patients requiring prolonged mechanical ventilation or airway protection. Understanding the clinical profile, indications, and microbiological characteristics of tracheostomized patients is essential for optimizing intensive care unit management and infection control. This study aimed to evaluate the demographic profile, indications, procedure type, microbiological pattern of organisms isolated from the tracheostomy stoma, and patient outcomes at follow-up.

A prospective, observational study was conducted in the department of otorhinolaryngology at a tertiary care medical center over 18 months (January 2024-June 2025). Seventy patients of all age groups who underwent tracheostomy were included. Demographic data, clinical indications, procedure type, and microbiological culture results from the stoma were recorded and analyzed.

Most patients were in the 51-60-year age group (25.70%) with male predominance (65.70%). Elective tracheostomy was performed in 68.60% of cases; all procedures were open surgical (100%). Culture positivity was noted in 45.70%, with methicillin-resistant Staphylococcus aureus (MRSA) (31.30%) and Pseudomonas aeruginosa (25.00%) as the most frequent isolates. Prolonged intubation was the leading indication (54.30%). Decannulation was achieved in 45.70% at follow-up. No statistically significant associations were found between gender or age and the nature of tracheostomy, or between the nature of the procedure and culture positivity (P > 0.05).

Tracheostomy predominantly involves middle-aged males, with trauma and neurological disorders as leading indications. MRSA and Gram-negative organisms are the principal colonizing pathogens, underscoring the need for stringent infection control and microbiological surveillance. Clinical severity rather than demographics determines procedural urgency.