Pulmonary bacterial infection
ETI was performed orally. This process might have moved bacteria from the upper airway to the lower tract, which could account for the bacterial colonization of the lower airways. This bacterial pathogen colonization from the respiratory airways – which was present in 25% of intubated patients – suggests a high prevalence of upper airway bacterial coinfection/colonization in AB patients, which is a risk factor for pneumonia.
Our study shows that 46% of patients on IMV presented with bacterial or multibacterial isolation in BAS in the infection range. This proportion is likely to be higher, since 66.7% of children with negative culture had received previous antibiotic therapy, which could have inhibitedin vitro bacterial growth.
These results are in line with previous studies that reported PBI occurred in 37%–44% of children with bronchiolitis admitted to PICUs27-29 and are consistent with the findings of other authors who found that bacterial isolation in the bloodstream, CSF, or urine in infants with RSV bronchiolitis is uncommon, and thatMoraxella catarrhalis and Haemophilus influenzae were the most frequent BAS-isolated microorganisms in patients requiring IMV30.
Our hospital is a tertiary level hospital that cares for children with complex and chronic pathologies. This fact explains the isolation of some typical nosocomial bacteria in ETA.