Role of anaerobic bacteria in infections following tracheostomy, intubation, or the use of ventilatory tubes in children.

Colonization of the tracheobronchial tree with microorganisms almost always follows tracheal intubation, tracheostomy, or the use of ventilatory tubes. Infection of the tracheostomy wound site frequently occurs after prolonged use of the tracheostomy. The long-term-ventilated child is at high risk for developing tracheobronchitis or nosocomial pneumonia, generally involving aerobic gram-negative or gram-positive bacteria. Several studies have illustrated the role of anaerobic bacteria in lower respiratory tract and tracheostomy wound site infection in intubated children. The predominant anaerobic bacteria were Peptostreptococcus spp and pigmented Prevotella and Porphyromonas spp. Most of these infections are due to polymicrobial aerobic-anaerobic bacterial flora. Appropriate management of mixed pulmonary aerobic and anaerobic infections requires the administration of antimicrobials that are effective against both the aerobic and anaerobic components of the infection.