title: Bacterial tracheitis: a multi-centre perspective.
abstract: The published literature on bacterial tracheitis is limited. We report the first multi-centre study of bacterial tracheitis together with a concise review of the literature. We conducted a retrospective study of cases admitted during the period 1993-2007 to 3 tertiary paediatric centres in the United Kingdom and 1 in Australia. A total of 34 cases were identified. 31 patients (91%) required intubation. Complications included cardiorespiratory arrest in 1, ARDS in 1, hypotension in 10, toxic shock syndrome in 1 and renal failure in 1 patient(s). Staphylococcus aureus was the most commonly implicated bacterial organism, isolated from the respiratory tract in 55.8% of the cases overall. Other pathogens commonly isolated from the respiratory tract included Streptococcus pyogenes (5.9%), Streptococcus pneumoniae (11.8%) and Haemophilus influenzae (11.8%). Viral coinfection was identified in 9 (31%) of the 29 cases in whom immunofluorescence testing was performed (influenza A in 4 cases; parainfluenza 1 in 2 cases; parainfluenza 3 in 2 cases; adenovirus in 1 case). The combined experience from 4 major paediatric intensive care units suggests that bacterial tracheitis remains a rare condition with an estimated incidence of approximately 0.1/100,000 children per year. Short-term complications were common but long-term sequelae were rare. There were no fatal outcomes, which contrasts with the high historical mortality rates and likely reflects improvements in intensive care management.
authors.affiliation: Department of Paediatrics, The University of Melbourne, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
authors.forename: Marc
authors.initials: M
authors.lastname: Tebruegge
authors.forename: Anastasia
authors.initials: A
authors.lastname: Pantazidou
authors.forename: Kent
authors.initials: K
authors.lastname: Thorburn
authors.forename: Andrew
authors.initials: A
authors.lastname: Riordan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Round
authors.forename: Claudine
authors.initials: C
authors.lastname: De Munter
authors.forename: Sam
authors.initials: S
authors.lastname: Walters
authors.forename: Nigel
authors.initials: N
authors.lastname: Curtis
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014136:Tracheitis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D006113:United Kingdom / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology; D014780:Viruses / Q000145:classification / Q000302:isolation & purification