Evidence map›Paper›PMID 38860585›Full record

Observational studyPediatric pulmonology2024

Factors associated with tracheostomy-associated infection treatment: A multicenter observational study.

John M Morrison, Naoko Kono, Margaret Rush, Andrea Hahn, Catherine S Forster, Jonathan D Cogen, Joanna Thomson, Sarah Hofman DeYoung, Sowgand Bashiri, Wendy J Mack and 4 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pediatric pulmonology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. Article
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  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

John M MorrisonDivision of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.ORCID http://orcid.org/0000-0003-2882-8849
Naoko KonoDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Margaret RushDepartment of Pediatrics, George Washington University School of Medicine and Health Sciences, Washingto, District Columbia, USA.
Andrea HahnDepartment of Pediatrics, George Washington University School of Medicine and Health Sciences, Washingto, District Columbia, USA.ORCID http://orcid.org/0000-0002-5117-0080
Catherine S ForsterDivisions of Pediatric Hospital Medicine and Pediatric Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jonathan D CogenDivision of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital/University of Washington, Seattle, Washington, USA.ORCID http://orcid.org/0000-0002-0382-6858
Joanna ThomsonDivision of Hospital Medicine, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Sarah Hofman DeYoungDivision of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital/University of Washington, Seattle, Washington, USA.
Sowgand BashiriDivisions of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.
Wendy J MackDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Michael N NeelyDivision of Infectious Disease, Children's Hospital Los Angeles, Los Angeles, California.
Tamara D SimonDivisions of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.
Christopher J RussellDivisions of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-5269-7861
Pediatric Research in Inpatient Settings Network

Funding

Diagnosis and management of pediatric tracheostomy-associated infectionsR01HS027619 · AHRQ · STANFORD UNIVERSITY · PI RUSSELL, CHRISTOPHER JOHN · 2021 to 2024
$1.9M
Prognostic modeling of pediatric tracheostomy-associated respiratory tract infectionsK23HL163331 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI John M Morrison · 2023 to 2026
$790k
AHRQ HHSAHRQ HHS R01 HS027619Gerber FoundationNHLBI NIH HHS K23 HL163331The Gerber Foundation and the Agency for Healthcare Research and Quality 1R01HS027619the National Heart, Lung, and Blood Institute, National Institutes of Health award 1K23HL163331
6 · The paper itself

Abstract

objectiveTo characterize factors that influence the decision to treat suspected pediatric bacterial tracheostomy-associated respiratory infections (bTRAINs; e.g., pneumonia, tracheitis).

methodsWe conducted a multicenter, prospective cohort study of children with pre-existing tracheostomy hospitalized at six children's hospitals for a suspected bTRAIN (receipt of respiratory culture plus ≥1 doses of an antibiotic within 48 h). The primary predictor was respiratory culture growth categorized as Pseudomonas aeruginosa, P. aeruginosa + ≥1 other bacterium, other bacteria alone, or normal flora/no growth. Our primary outcome was bTRAIN treatment with a complete course of antibiotics as documented by the discharge team. We used logistic regression with generalized estimating equations to identify the association between our primary predictor and outcome and to identify demographic, clinical, and diagnostic testing factors associated with treatment.

resultsOf the 440 admissions among 289 patients meeting inclusion criteria, 307 (69.8%) had positive respiratory culture growth. Overall, 237 (53.9%) of admissions resulted in bTRAIN treatment. Relative to a negative culture, a culture positive for P. aeruginosa plus ≥1 other organism (adjusted odds ratio [aOR] 2.3; 95% confidence interval [CI] 1.02-5.0)] or ≥1 other organism alone (aOR: 2.8; 95% CI: 1.4-5.6)] was associated with treatment. Several clinical and diagnostic testing (respiratory Gram-stain and chest radiograph) findings were also associated with treatment. Positive respiratory viral testing was associated with reduced odds of treatment (aOR: 0.5; 95% CI: 0.2-0.9).

conclusionsPositive respiratory cultures as well as clinical indicators of acute illness and nonculture test results were associated with bTRAIN treatment. Clinicians may be more comfortable withholding antibiotics when a virus is identified during testing.

Indexed as

Anti-Bacterial AgentsTracheostomyAdolescentChildChild, PreschoolFemaleHumansInfantMaleProspective StudiesPseudomonas aeruginosaPseudomonas InfectionsRespiratory Tract InfectionsTracheitisAnti-Bacterial AgentspediatricspneumoniaPseudomonas aeruginosatracheitistracheostomy

Identifiers

PMID38860585
PMCPMC11783139

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.