Published: 2020-03-25

A descriptive study to determine the bacterial flora and antibiotic sensitivity of lower respiratory tract in tracheostomised patients

Kulkarni Manik Rao, Panchami .


Background: Tracheostomy is one of the commonest operations performed by an otorhinolaryngologist for various indications and in different age groups and tracheo-bronchitis is a common complication in tracheostomised  patients. This study designed to determine the bacterial flora and antibiotic sensitivity of lower respiratory tract following tracheostomy in hospitalized patients.

Methods: This is a descriptive study of 50 tracheostomised patients carried out from December 2017 to May 2019, at VIMS Ballari.  

Results: Stridor was the most common indication for tracheostomy (70%). Tracheal aspirate was sent for bacterial culture and sensitivity on day 0, 1 week and 3 weeks post tracheostomy. Majority of the patients showed no growth in the day 0 and 3weeks post tracheostomy bacterial cultures of the tracheal aspirate. Bacterial cultures yielded growth in majority of the patients in the 1-week post tracheostomy cultures. The sensitivity pattern, intermediate response pattern and resistance pattern to the first line antibiotics that are regularly used in our hospital were studied in all the 3 samples of tracheal aspirates that were sent for bacterial culture from all the 50 tracheostomised patients.

Conclusions: It is a good practice to send the tracheal aspirate for culture and sensitivity following Tracheostomy. If the patient is started on suitable antibiotics based on the culture postoperative recovery will be hastened, risk of postoperative infections like tracheitis, tracheobrochitis, stoma site infection and other lower respiratory tract infections can be reduced.


Tracheostomy, Stridor, Tracheitis, Tracheobronchitis

Full Text:



Gleeson M. Scott-Browns Otorhinolaryngology, Head and Neck Surgery. 7th ed, Hodder Arnold Publishers. 2008;2:2292-3.

Watkinson JC, Gaze MN, Wilson JA. Stell and Maran's head and neck surgery. 5th Edition. Hodder Arnold Publishers. 2012: 274-275.

Maheshwari PK, Khan MR, Haque A. Elective tracheostomy in mechanically ventilated children. JCPSP. 2012;22(6):414-5.

Baron S. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston, 1996.

Morar P, Makura Z, Jones A, Baines P, Selby A, Hughes J et al. Topical antibiotics on tracheostoma prevents exogenous colonization and infection of lower airways in children. Chest. 2000;117(2):513-8.

Morar P, Singh V, Makura Z, Jones AS, Baines PB, Selby A et al. Oropharyngeal carriage and lower airway colonization or infection in 45 tracheotomised children. Thorax. 2002;57:1015-20.

Niederman MS, Ferranti RD, Zeigler A. Respiratory infections complicating longterm tracheostomy: the implications of persistent Gram-negative tracheobronchial colonization. Chest. 1984;85:39-44.

Palmer LB, Donelan SV, Fox G. Gastric flora in chronically mechanically ventilated patients: relationship to upper and lower airway colonization. Am J Respir Crit Care Med.1995;151:1063-7.

Adeyi AA, Nuhu DM. Indications and outcome of tracheostomy: results from a Nigerian tertiary hospital. BMC Surg. 2010;10:2.

Aswin M, Panduranga MK, Shrikala B, Vijendra SS, Kiran MB. Bacterial flora of the lower respiratory tract during and after a week of tracheostomy. Medpulse Int Med J. 2017;4(1):92-8.

Hemanth MR, Yelma BR. A Clinical Study to Compare the Bacterial Flora of Lower Respiratory Tract immediately after Tracheostomy and during First Tube Change. Scholars J Appli Medi Sci. 2016;4(10):3776-81.

Hilty M, Burke C, Pedro H, Cardenas P, Bush A, Bossley C et al. Disordered microbial communities in asthmatic airways. PLOS one. 2010;5(1):5.

Pratirodh K, Dwij RB, Prakash G, Bharat MP, Upendra D. Bacteriological Profile of Tracheal Aspirates of the Patients Attending a Neuro-hospital of Nepal. Int J Life Sci. 2010;4:60-5.