Management Of Pseudomonas Aeruginosa Infection In Children With Long-Term O-2, Long-Term Ventilation Or Tracheostomy

Introduction: Pseudomonas aeruginosa (PA) is associated with worsening morbidity and mortality in children with long term O 2 , long term ventilation or tracheostomy. There are currently no guidelines for management of PA in these patients. Aim: To report on incidence and management of PA infection in children with long term O 2 , long term ventilation or tracheostomy. Methods: All children with long term O 2 therapy, ventilation or tracheostomy and initial PA infection, at King9s College Hospitals from January 2010 to August 2015 were included. PA infection was defined as isolation of PA from a respiratory sample. Patients with cystic fibrosis or bronchiectasis were excluded. Cases were identified using diagnostic codes. Electronic medical records were reviewed for demographics, presentation, comorbidities and management. Results: There were 30 children with long term O2 (10% grew PA), 27 on long term ventilation (30% grew PA) and 7 with tracheostomy (85% grew PA). There was huge variability in respiratory sampling practices (range 0 to 5 samples per month), with more frequent sampling in tracheostomy patients. Treatment was initiated in 13 (76%) and eradication was achieved in 50% of treated patients. Conclusions: Many patients on long term O 2 therapy, ventilation or tracheostomy grew PA with huge variation in management practices. There is need for further research and consensus for management of these patients.