Bacterial tracheitis in pediatrics: 12 year experience at a medical center in Taiwan.
BACKGROUND
Bacterial tracheitis may cause life-threatening airway obstruction.


METHODS
Records of patients admitted to the pediatric wards of Mackay Memorial Hospital between 1994 and 2005 with a diagnosis of bacterial tracheitis made on bronchoscopic visualization of thick membranous tracheal secretions were retrospectively reviewed.


RESULTS
A total of 40 patients (aged 1 month-8 years, 29 [73%] under 3 years old) were included. Cough, fever, dyspnea, and hoarseness were the commonest symptoms. Fourteen patients (21%) required intubation. The most frequently isolated bacteriae were alpha-hemolytic streptococcus (in 11, 38%), pseudomonas (5, 17%), and Staphylococcus aureus (4, 14%). Intubation was more frequent in patients seen between 1994 and 1999 compared with those seen later (8/12 early vs 9/28 late). In the early period alpha-hemolytic streptococcus (55%) and pseudomonas (36%) were isolated. In the later period the most frequently isolated bacteria was alpha-hemolytic streptococcus (28%), followed by S. aureus (22%). No patients died, but those with pseudomonas infection had more severe complications, including tracheal stenosis. The average hospital stay in the early period was 26.2 +/- 20.5 days versus 9.1 +/- 4.8 days in the late period. The corresponding lengths of stay in the intensive care unit were 10.5 +/- 11.5 days and 2.0 +/- 2.2 days.


CONCLUSIONS
Bacterial tracheitis requiring hospitalization of children appeared to be milder in the second half of the study period. Pseudomonas tracheitis tends to have a severe course.
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Yu-Lan
YL
Huang
Chun-Chih
CC
Peng
Nan-Chang
NC
Chiu
Kuo-Sheng
KS
Lee
Han-Yang
HY
Hung
Hsin-An
HA
Kao
Chyong-Hsin
CH
Hsu
Jui-Hsin
JH
Chang
Fu-Yuan
FY
Huang
D001424:Bacterial Infections / Q000453:epidemiology / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014136:Tracheitis / Q000453:epidemiology / Q000503:physiopathology