Pediatric tracheostomy: epidemiology and characterization of tracheal secretion - a literature review

• Autor(a) principal: Barros,Caroline Espíndola de
• Data de Publicação: 2019
• Outros Autores: Almeida,Juliana Afonso de, Silva,Mariana Helena e, Ayres,Gustavo Henrique da Silva, Oliveira,Camilla Gabriela de, Braga,Carla Afonso da Silva Bitencourt, Avelino,Melissa Ameloti Gomes
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista da Associação Médica Brasileira (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302019001201502
• topic: Child; Trachea; Infection; Biofilms; Pseudomonas aeruginosa; Staphylococcus aureus

SUMMARY INTRODUCTION Despite the benefits, tracheostomized children are susceptible to respiratory infections, since the tube is located in a strategic region where there is colonization by several bacteria and biofilm formation. Biofilm is formed when the bacteria adhere strongly to the surfaces of the tubes, providing protection against various types of aggression, such as antibiotic treatment. OBJECTIVE To carry out a literature review of the last ten years on tracheostomized pediatric patients, in order to characterize the bacteria isolated in children’s tracheal secretions, and verify which ones are the most frequent. METHODS Two authors searched the Lilacs, SciELO, Medline Plus, and PubMed databases. The MeSH terms used were: ‘tracheostomy’ and ‘tracheotomy’ associated with ‘infections’, ‘children’, ‘child’, and ‘bacterial’ as qualifiers. RESULTS Of the 512 studies on the subject, 19 were selected for review. The total number of children evaluated in the studies was 4,472, with a mean age of 7.5 years. As for the bacteria found in the secretions of tracheostomized children, 12 species of bacteria were more frequent, P. aeruginosa was the predominant bacterium, followed by S. aureus (63.1%), Klebsiella pneumoniae (57.8%), Streptococcus pneumoniae (47.3%), and Stenotrophomonas maltophilia (47.3%). CONCLUSION One of the main complications treated in tracheostomized patients were infections, since the respiratory system is colonized by several bacteria that can cause serious infections, which are associated with the formation of biofilms. The predominant bacterium in most of the studies was P. aeruginosa, and the second species commonly reported was S. aureus.