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J Korean Soc Laryngol Phoniatr Logop > Volume 32(1); 2021 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2021;32(1): 29-34.
doi: https://doi.org/10.22469/jkslp.2021.32.1.29
장기간 기관절개공을 유지한 소아 환자들에서의 기도 세균집락에 관한 연구: 균동정 부위와 시차 간의 차이 비교
한승훈1 , 김영석1 , 권성근1,2
1서울대학교병원 이비인후과
2서울대학교 의과대학 이비인후과학교실
Respiratory Tract Bacterial Colonization in Long-Term Tracheostomized Pediatric Patients: Comparison between Sites and Two Different Timepoints
Seung Hoon Han1 , Young Seok Kim1 , Seong Keun Kwon1,2
1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
2Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
Correspondence  Seong Keun Kwon ,Tel: +82-2-2072-2286, Fax: +82-2-745-2387, Email: otolarynx@snuh.org
Received: 15 December 2020; Revised: January 13, 2021   Accepted: 28 January 2021.  Published online: 28 April 2021.
ABSTRACT
Background and Objectives
s Tracheostomy lead to persistent bacterial colonization of the respiratory tract. Surgical site infection and restenosis by the pathogenic bacteria is the most fatal complication after open airway surgery. The aim of this study is to describe the culture results of larynx and tracheostoma in patients with tracheostomy and the preoperative, intraoperative culture results in patients underwent open airway surgery.
Materials and Method
A retrospective review was performed on 18 patients who underwent culture between 2017 and 2019.
Results
Pseudomonas or antibiotic resistance bacteria were identified in 11 patients out of 18 patients (61.1%); Ceftriaxone-resistant Streptococcus (38.9%), Pseudomonas (33.3%), Methicillin- resistant Staphylococcus aureus (16.7%), extended-spectrum β-lactamases (ESBL) producing Klebsiella pneumoniae (11.1%). Among 18 patients, 6 patients showed the different culture result between larynx and tracheostoma. In 4 out of 10 patients who underwent open airway surgery, the bacteria were not identified before surgery, but the bacteria were isolated in the intraoperative culture. In one patient, the bacteria detected intraoperatively were different from those detected before surgery.
Conclusion
Preoperative respiratory tract culture and usage of perioperative antibiotics according to the culture are necessary. It is crucial to verify the bacterial culture in both tracheostoma and larynx. And it should be performed immediately before open airway surgery.
KEY WORDS: Subglottic stenosis; Tracheostomy; Bacterial culture test; Antimicrobial susceptibility test; Prophylactic antibiotics
중심 단어: 성문하협착, 기관절개술, 균 배양검사, 항생제 감수성, 예방적 항생제
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