@article {McLarenPA986, author = {Dythea McLaren and Marie Chitakis and Hannah Burns and Nitin Kapur}, title = {Airway microbiology in tracheostomised children}, volume = {54}, number = {suppl 63}, elocation-id = {PA986}, year = {2019}, doi = {10.1183/13993003.congress-2019.PA986}, publisher = {European Respiratory Society}, abstract = {Tracheostomised children frequently isolate potentially pathogenic micro-organisms (PPM). We aimed to describe upper airway microbiology as found on endotracheal aspirate (ETA) in tracheostomised children and correlate it with lower airway microbiology via bronchoalveolar lavage fluid (BALF).We retrospectively reviewed airway microbiology of all tracheostomised children currently attending Queensland Children{\textquoteright}s Hospital. Sub-analysis was on ventilatory and multi-drug resistant organism (MRO) status. Sensitivity and specificity of ETA for P.aeruginosa \& S.aureus were calculated against concomitant BALF culture (n=37).From 43 children (25 male, median age 68 months, 14 ventilated), 16 different PPM were isolated [mean(SD) 3.30(2.23)]. S.aureus (n=33,77\%) and P.aeruginosa (n=29,67\%) predominated. Ventilated children isolated significantly more types of PPM [mean(SD) 4.57(2.14)] than non-ventilated children [mean(SD) 2.69(2.04)] p=0.011; with 93\% of those ventilated isolating S.aureus and 86\% P.aeruginosa. MROs were present in 12 (28\%) children, 8 (86\%) of these were ventilated. MRSA was isolated in 9 (21\%) children with 6 (67\%) ventilated. For P.aeruginosa and S.aureus, ETA had high sensitivity (95\%, 100\%) but low specificity (64.7\%, 33.3\%) compared to BALF.In children with tracheostomy, predominant respiratory bacterial pathogens are S.aureus and P.aeruginosa, with MRSA less frequent than previously described[ref]. Ventilated patients isolate MRO more frequently. A negative ETA potentially rules out lower airway S.aureus and P.aeruginosa. Adequately powered prospective studies with quantitative cultures could enhance understanding and guide therapy.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA986.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/54/suppl_63/PA986}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }