EC Microbiology

Objective: To determine the resistant bacteria in children with prolonged tracheostomy (> 2 weeks).

Methods: This observational cross-sectional study was performed on all PICU admitted children with prolonged (> 2 weeks) tracheostomy during 4 years. After initial exams, the culture was taken and transported in the transport medium. The organisms were identified and antibiotic susceptibility first by disc method and E test method in resistant cases had done. Chi-square values were calculated for all categories. P value < 0.05 was considered significant.

Results: From 51 samples (18 cases); 94% of cases had at least one positive culture. A. baumannii (47%) was the most common of samples. The frequency of K. pneumonia, P. aeruginosa and MRSA was 26%, 12%, and 7%, respectively. All S. aureus (100%) were sensitive to linezolid but just 33% were sensitive to trimethoprim. Acinetobacter, E. coli and K. pneumonia were 100% sensitive to colistin. P. aeruginosa was resistant (85%) to ceftazidime. The highest resistance rate (100%) were observed for ciprofloxacin, clindamycin, erythromycin, oxacillin and penicillin. Determination the MIC level (E-test) had done for 7 grams negative organisms (colistin) and 2 MRSA (vancomycin). Duration of tracheostomy and previous antibiotic usage had a good correlation with positive culture and presence of high antibiotic resistance organisms. But no correlation observed between duration of tracheostomy and underlying disease.

Conclusion: Given the long-term of tracheostomy with complications such as infection and their antibiotic resistance pattern, care should be taken during hospitalization in preventing these patients to infection. The rational use of antibiotics would prevent the antibiotic resistance in children with prolonged tracheostomy.

 Keywords: Bacterial Strains; Antibiotic; Resistance; Children; Long-Term Tracheostomy

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