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Bacterial colonization of endotracheal tubes in intubated neonates. Arch Otolaryngol Head Neck Surg 2001 May;127(5):525-8

Date

05/18/2001

Pubmed ID

11346427

DOI

10.1001/archotol.127.5.525

Scopus ID

2-s2.0-0035041520   27 Citations

Abstract

OBJECTIVE: To obtain in vivo bacterial colonization profiles on endotracheal tubes at different sites in the neonatal airway in an attempt to better characterize one potential element of chondritis.

DESIGN: A case series in which cultures were obtained from calculated segments of 33 endotracheal tubes immediately following extubation. This allowed for sampling at specific levels of the airway corresponding to the trachea, the subglottis, and the oropharynx. Data collected included gender, race, duration of intubation, use of antibiotic therapy, comorbidities, gestational age at birth and extubation, crown-rump length, weight, radiographic distance from tube tip to carina, and culture results.

SETTING: Newborn intensive care unit at a tertiary care medical center.

PATIENTS: Twenty-nine neonates intubated for longer than 24 hours (range, 24 hours to 15 days).

MAIN OUTCOME MEASURES: Bacterial and fungal cultures obtained from 3 endotracheal tube segments for each extubation.

RESULTS: A statistically significant difference (P < .05) was found in colonization rates between patients intubated for less than 4 days and those intubated for longer periods. No significant difference was noted in bacterial profile between the 3 sites.

CONCLUSIONS: Data demonstrate that bacterial colonization of an indwelling object in the neonatal airway increases with the duration of intubation. Furthermore, 4 days seems to represent a critical period in the formation of such colonization (possibly in the form of a biofilm). These bacteria may contribute to the chondritis known to precede the development of subglottic stenosis. Further studies are indicated to suggest ways to interrupt this process and reduce the incidence of airway injury.

Author List

Friedland DR, Rothschild MA, Delgado M, Isenberg H, Holzman I

Author

David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Bacteria
Equipment Contamination
Female
Humans
Infant, Newborn
Intubation, Intratracheal
Male
Time Factors