A Clinical Study to Compare the Bacterial Flora of Lower Respiratory Tract immediately after Tracheostomy and during First Tube Change

Tracheostomy directly exposes the lower respiratory tract to the exogenous bacteria increasing the risk of colonization of lower respiratory tract. The present study was done in patients who underwent tracheostomy and the study compares bacterial flora of oropharnyx and lower respiratory tract during tracheostomy with that of the bacterial flora of the lower respiratory tract during the first tube change. Forty patients were included in this study. During tracheotomy, a sterile suction catheter was introduced into the trachea and suction was done. Tip of the suction tube was sent for bacterial culture. Tracheostomy tube was changed after 2 – 11 days. During the tube change, tracheal suctioning was done using sterile suction catheter and the tip of suction catheter was sent for the Bacterial culture. 95% of the study population was intubated before tracheostomy. 40% had positive growth from oropharnyx during tracheostomy, most common bacteria isolated being Enterobacter spp. 20%, (n=8). Only 17.5% had positive growth from trachea during tracheostomy, most common bacteria isolated being Acinetobacter 5%, (n=2). 80% had positive growth from trachea during the first tube change. Colonization of the lower respiratory tract following tracheostomy is mainly by the exogenous bacteria, comprising of Enterobacter (27.5%), Acinetobacter Baumanii (22.5%) and E. coli (20.0%). Colonization of the lower respiratory tract after tracheostomy happens primarily from the exogenous route. Tracheal colonization present at the time of tracheostomy is not significant and does not significantly correlate with the tracheal colonization post tracheostomy. There is no significant influence on the tracheal colonization post tracheostomy by place of performance of tracheostomy.