Risk factors associated with microbial colonisation and infection of tracheostomy tubes

Dulitha Kumarasinghe; Eugene Wong; Marin Duvnjak; Niranjan Sritharan; Mark C Smith; Carsten Palme; Faruque Riffat

doi:10.1016/j.amjoto.2020.102495

Risk factors associated with microbial colonisation and infection of tracheostomy tubes

Am J Otolaryngol. 2020 Jul-Aug;41(4):102495. doi: 10.1016/j.amjoto.2020.102495. Epub 2020 Apr 18.

Authors

Dulitha Kumarasinghe¹, Eugene Wong², Marin Duvnjak¹, Niranjan Sritharan¹, Mark C Smith³, Carsten Palme⁴, Faruque Riffat³

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW 2006, Australia.
² Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW 2006, Australia; Department of Otolaryngology, Head and Neck Surgery, Macquarie University Hospital, Australia. Electronic address: eugene.hl.wong@gmail.com.
³ Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW 2006, Australia; Department of Otolaryngology, Head and Neck Surgery, Macquarie University Hospital, Australia; Chris O'Brien Lifehouse, Sydney, Australia.
⁴ Chris O'Brien Lifehouse, Sydney, Australia.

PMID: 32334923
DOI: 10.1016/j.amjoto.2020.102495

Abstract

Background: A long-term tracheostomy tube has the potential to cause significant morbidity and mortality in both hospitalised patients and those in the community. This study aims to assess the rates of microbial colonisation and infection of tracheostomy tubes.

Materials and methods: Consecutive patients were enrolled from both inpatient and outpatient settings during their routine tracheostomy changes. During changes, culture swabs were taken from the cuff/outer-cannula and inner-cannula. Analysis were performed to compare culture results with risk factors.

Results: 65 patients were enrolled in the study. Inpatients (65.9% vs 38.1%, χ² 4.48, p = 0.03), increasing acuity of care (from outpatient; ward; HDU; and ICU in increasing acuity) (τ_b = 0.289, p = 0.012), cuffed tracheostomy tubes, (66.7% vs 39.1%; χ² 4.59, p = 0.032); diabetics (64.6% vs 35.3%; χ² 4.39, p = 0.036); and males were associated with increased colonisation (72.4% vs 44.4%; χ² 5.12, p = 0.024).

Conclusion: Factors associated with an increase in colonisation and infection of tracheostomy tubes were location, and in males, diabetics and in cuffed tubes.

Keywords: Colonisation; Diabetes; Infection; Smoking; Tracheostomy.

MeSH terms

Adult
Aged
Bacterial Infections / etiology*
Bacterial Infections / microbiology*
Cannula / microbiology*
Diabetes Mellitus
Equipment Failure
Female
Humans
Male
Middle Aged
Risk Factors
Sex Factors
Tracheostomy / adverse effects*
Tracheostomy / instrumentation*