Study Cohort
Among 170 children with BPD and tracheostomies included during the
9-year study period, 2,103 bacterial respiratory cultures were obtained
(median 10 cultures per child over their 3 years of enrollment,
IQR:3-17, full range 1-45, Table 1 ). Children had a median age
at tracheostomy placement of 4.1 months (IQR: 3.2-5.3 months). Children
had a median 5 CCCs per child (IQR: 4-6) and 67.6% required baseline
chronic ventilator use at some point in their 3 years
post-tracheostomy.
Over half (59.4%) of children had any pathogen identified on bacterial
isolation on respiratory cultures during the 3-years post-tracheostomy
(Table 1, Figure 1 ). Among children with pathogens identified,
the median time to first pathogen post-tracheostomy placement was 3.7
months (IQR: 0.9-11.5 months). Among children with any P.
aeruginosa , the median time to first P. aeruginosapost-tracheostomy placement was 3.3 months (IQR: 0.8-11.2 months).
Compared with children who never had pathogens identified, children with
any pathogen identification were more likely to be privately insured
(45.5% vs. 23.2%, p=0.003), but there were no differences in gender,
race, or ethnicity. Children with pathogen identification had more CCCs
(median 5 CCCs [IQR: 4-6] vs. 4 CCCs [IQR: 3-6], p=0.04) and
were also more likely to use a ventilator at baseline (74.3% vs.
58.0%, p=0.03). Children with pathogen identification had approximately
three times more cultures collected per child compared with children
without pathogen identification (median 12 [IQR: 7-18] vs. 4 [IQR:
2-13], p<0.001).