Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings

Ebru Şahin; Kübra Boydağ Güvenç; Özlem Mustafaoğlu; Fatih Varol; Cansu Durak; Şirin Güven

Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings

Abstract

Aims: Children with tracheostomies are at increased risk for respiratory tract infections and resistant pathogens due to impaired airway defense mechanisms, frequent healthcare exposure, and extensive antibiotic use. This study aimed to compare the microbiological characteristics of tracheal aspirate cultures, antimicrobial resistance patterns, and clinical outcomes according to pre-admission care setting (home care or long-term care facility) in children with established tracheostomies admitted to the pediatric intensive care unit (PICU) with pneumonia. Methods: This single-center, retrospective, observational study included children with tracheostomies admitted to the PICU with pneumonia. A total of 54 patients with positive tracheal aspirate cultures obtained at admission were analyzed. Results: Of the 54 patients, 31 were in the home care group and 23 in the long-term care facility (LTCF) group. Patients admitted from LTCFs were significantly older (median 15 months vs. 7 months; p=0.003). Gram-negative bacteria predominated in tracheal aspirate cultures in both groups. The distribution of pathogens differed by care setting: Klebsiella pneumoniae was more frequently isolated in the home care group, whereas Pseudomonas aeruginosa was significantly more common in the LTCF group. High rates of ≥MDRO and ≥XDR were observed in both groups without significant differences. Mortality was higher in the LTCF group; however, this finding should be interpreted cautiously due to baseline differences between groups (34.8% vs. 9.7%; p=0.024). Conclusion: Gram-negative pathogens predominate in children with tracheostomies, and pathogen distribution may vary according to care setting. The high resistance burden highlights the importance of careful empirical antimicrobial selection. Higher mortality among patients admitted from long-term care facilities warrants further investigation in larger, prospective studies.

Keywords

Supporting Institution

This study was not supported by any sponsor or funder.

Ethical Statement

Ethics approval This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Scientific Research Ethics Committee of Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital (Approval Date: January 14, 2026; Approval No: 2026/13; Document No: E-46059653-050.04-301792728). Due to the retrospective nature of the study, the requirement for informed consent was waived by the ethics committee.

References

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Details

Primary Language

English

Subjects

Pediatric Intensive Care

Journal Section

Research Article

Authors

Ebru Şahin ^*
0000-0002-7532-7724
Türkiye

Kübra Boydağ Güvenç
0000-0003-3881-6980
Türkiye

Özlem Mustafaoğlu
0000-0001-8915-6922
Türkiye

Fatih Varol
0000-0002-2424-6887
Türkiye

Cansu Durak
0000-0001-6309-8859
Türkiye

Şirin Güven
0000-0001-8727-5805
Türkiye

Publication Date

June 25, 2026

Submission Date

January 21, 2026

Acceptance Date

April 7, 2026

Published in Issue

Year 2026 Volume: 7 Number: 3

IZ

https://izlik.org/JA45CW99LG

Cite

RIS / Bibtex

APA

Şahin, E., Boydağ Güvenç, K., Mustafaoğlu, Ö., Varol, F., Durak, C., & Güven, Ş. (2026). Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings. Journal of Medicine and Palliative Care, 7(3), 438-443. https://izlik.org/JA45CW99LG

AMA

1.Şahin E, Boydağ Güvenç K, Mustafaoğlu Ö, Varol F, Durak C, Güven Ş. Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings. J Med Palliat Care / JOMPAC / jompac. 2026;7(3):438-443. https://izlik.org/JA45CW99LG

Chicago

Şahin, Ebru, Kübra Boydağ Güvenç, Özlem Mustafaoğlu, Fatih Varol, Cansu Durak, and Şirin Güven. 2026. “Pneumonia Pathogens and Antimicrobial Resistance in Children With Tracheostomies: A Comparison of Care Settings”. Journal of Medicine and Palliative Care 7 (3): 438-43. https://izlik.org/JA45CW99LG.

EndNote

Şahin E, Boydağ Güvenç K, Mustafaoğlu Ö, Varol F, Durak C, Güven Ş (June 1, 2026) Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings. Journal of Medicine and Palliative Care 7 3 438–443.

IEEE

[1]E. Şahin, K. Boydağ Güvenç, Ö. Mustafaoğlu, F. Varol, C. Durak, and Ş. Güven, “Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 3, pp. 438–443, June 2026, [Online]. Available: https://izlik.org/JA45CW99LG

ISNAD

Şahin, Ebru - Boydağ Güvenç, Kübra - Mustafaoğlu, Özlem - Varol, Fatih - Durak, Cansu - Güven, Şirin. “Pneumonia Pathogens and Antimicrobial Resistance in Children With Tracheostomies: A Comparison of Care Settings”. Journal of Medicine and Palliative Care 7/3 (June 1, 2026): 438-443. https://izlik.org/JA45CW99LG.

JAMA

1.Şahin E, Boydağ Güvenç K, Mustafaoğlu Ö, Varol F, Durak C, Güven Ş. Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings. J Med Palliat Care / JOMPAC / jompac. 2026;7:438–443.

MLA

Şahin, Ebru, et al. “Pneumonia Pathogens and Antimicrobial Resistance in Children With Tracheostomies: A Comparison of Care Settings”. Journal of Medicine and Palliative Care, vol. 7, no. 3, June 2026, pp. 438-43, https://izlik.org/JA45CW99LG.

Vancouver

1.Ebru Şahin, Kübra Boydağ Güvenç, Özlem Mustafaoğlu, Fatih Varol, Cansu Durak, Şirin Güven. Pneumonia pathogens and antimicrobial resistance in children with tracheostomies: a comparison of care settings. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Jun. 1;7(3):438-43. Available from: https://izlik.org/JA45CW99LG