Background: A long-term tracheostomy tube has the potential to cause significant morbidity and mortality in both hospitalised patients and those in the community. This study aims to assess the rates of microbial colonisation and infection of tracheostomy tubes. Materials and methods: Consecutive patients were enrolled from both inpatient and outpatient settings during their routine tracheostomy changes. During changes, culture swabs were taken from the cuff/outer-cannula and inner-cannula. Analysis were performed to compare culture results with risk factors. Results: 65 patients were enrolled in the study. Inpatients (65.9% vs 38.1%, chi(2) 4.48, p = 0.03), increasing acuity of care (from outpatient; ward; HDU; and ICU in increasing acuity) (tau(b) = 0.289, p = 0.012), cuffed tracheostomy tubes, (66.7% vs 39.1%; chi(2) 4.59, p = 0.032); diabetics (64.6% vs 35.3%; chi(2) 4.39, p = 0.036); and males were associated with increased colonisation (72.4% vs 44.4%; chi(2) 5.12, p = 0.024). Conclusion: Factors associated with an increase in colonisation and infection of tracheostomy tubes were location, and in males, diabetics and in cuffed tubes.

Tracheostomy‐tube change protocols are implemented primarily due to concern regarding infections. Currently changes vary from within 4 weeks post‐insertion to 3 monthly thereafter. However, currently no evidence‐based guidelines exist to justify these protocols. This study aims to assess the colonization of tracheostomy‐tubes associated with the frequency of changes.