BACKGROUND Children with tracheostomy are at increased risk for respiratory tract infections, yet the risk involved in tracheostomy related infections is unclear. METHODS We conducted a retrospective review of the medical records of children who underwent tracheostomy between January 2002 and December 2016 at a teaching hospital in Taipei. Demographics, underlying disease, indication for tracheostomy, laboratory data and management, and long-term outcome data were collected. Infection episodes were grouped into definite, possible, non-bacterial pneumonia, and local infection groups. RESULTS Ninety patients were enrolled. Forty-two (46.7%) patients had infections that required hospitalization. Definite bacterial pneumonia accounted for 12 (8.5%) episodes, 113 episodes (80.1%) were possible bacterial pneumonia, 12 (8.5%) were non-bacterial pneumonia, and 4 (2.8%) were local infections. Patients with definite and possible bacterial pneumonia were found to have a longer hospital duration than patients with non-bacterial pneumonia (p=0.024), with mean hospitalization stays of 8.83±5.59 days and 5.67±2.55 days, respectively. The median duration from tracheostomy to bacterial pneumonia was 1.78 years (range, 0.04- 11.38) whereas for the non-bacterial pneumonia group it was 0.57 years (range, 0.04-6.61). Cerebral palsy (CP) (adjusted odds ratio [AOR] 3.65; 95% confidence interval [CI]: 1.11-11.99; p=0.033) and gastroesophageal reflux disease (GERD) (AOR 2.84; 95% CI: 1.09-7.38; p=0.033) were independently associated with respiratory tract infections in these children. CONCLUSION In this study, CP and GERD were associated with infections in children with tracheostomy. Bacterial and non-bacterial pneumonia are difficult to differentiate clinically which may lead to unnecessary antibiotics use.

中文翻译：

---

气管切开术患儿的呼吸道感染。

背景技术气管切开术的儿童呼吸道感染的风险增加，但是与气管切开术相关的感染涉及的风险尚不清楚。方法我们对2002年1月至2016年12月在台北市一家教学医院接受气管切开术的儿童的病历进行了回顾性研究。收集了人口统计资料，潜在疾病，气管切开术的适应症，实验室数据和管理以及长期结果数据。感染发作分为明确的，可能的，非细菌性肺炎和局部感染组。结果纳入患者90例。四十二（46.7％）名患者患有需要住院的感染。确诊细菌性肺炎占12例（8.5％），其中113例细菌性肺炎（80.1％）可能为细菌性肺炎12例（8。非细菌性肺炎占5％），局部感染占4（2.8％）。发现具有确定性和可能的​​细菌性肺炎的患者比非细菌性肺炎的患者住院时间更长（p = 0.024），平均住院时间分别为8.83±5.59天和5.67±2.55天。从气管切开术到细菌性肺炎的中位持续时间为1.78年（范围0.04至11.38），而非细菌性肺炎组的中位持续时间为0.57年（范围0.04至6.61）。脑性瘫痪（CP）（调整后的优势比[AOR] 3.65； 95％置信区间[CI]：1.11-11.99； p = 0.033）和胃食管反流病（GERD）（AOR 2.84； 95％CI：1.09-7.38； p = 0.033）与这些儿童的呼吸道感染独立相关。结论在本研究中，CP和GERD与气管切开术患儿的感染有关。细菌性和非细菌性肺炎在临床上难以区分，这可能导致不必要的抗生素使用。