{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:04:51Z","timestamp":1792623891706,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective\/Background<\/jats:title>\n                    <jats:p>Children with tracheostomies are at an increased risk of bacterial respiratory tract infections. Infections caused by multidrug\u2010resistant organisms (MDROs) are more difficult to treat and can result in severe complications. This study aimed to investigate the risk factors and sequelae of MDRO positivity in tracheostomy and chronic ventilator\u2010dependent children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective chart review of 75 tracheostomy and chronic ventilator\u2010dependent children at St. Louis Children's Hospital. Data on demographics, respiratory cultures, hospitalizations, emergency department (ED) visits, and antibiotic usage were collected. We determined the frequency of MDRO positivity and compared the number of hospitalizations, number of ED visits, and antibiotic usage in patients with and without MDRO\u2010positive cultures. Patient clinical variables were analyzed before and after MDRO acquisition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found 75.7% (56\/74) of our participants had an MDRO\u2010positive culture, with methicillin\u2010resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (MRSA,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936, 64%) and\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098, 14%) being the most commonly detected organisms. Participants with a greater number of annual nonpulmonary admissions (odds ratio [OR]\u2009=\u20091.99, 95% confidence interval [CI] (1.21\u20133.29),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008], inpatient antibiotic courses [OR\u2009=\u20091.27, 95% CI (1.07\u20131.50),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006], total antibiotic courses [OR\u2009=\u20091.26, 95% CI (1.08\u20131.48),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004], and chronic antibiotic use [OR\u2009=\u20092.31, 95% CI (1.12\u20134.74),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03] were at an increased risk for MDRO positivity. Those who were MDRO\u2010positive had more pulmonary admissions following MDRO acquisition compared those who were MDRO\u2010negative [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005] but not more antibiotic usage or ED visits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frequent antibiotic usage and hospitalizations increase the risk of MDRO acquisition in children with tracheostomies and ventilator\u2010dependence. Further antibiotic stewardship may help prevent resistant infections in technology\u2010dependent children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.26152","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T23:54:23Z","timestamp":1663113263000},"page":"26-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Airway multidrug\u2010resistant organisms in a population of tracheostomy and chronic ventilator\u2010dependent children at a tertiary care pediatric hospital"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5701-3078","authenticated-orcid":false,"given":"Tara N.","family":"Havens","sequence":"first","affiliation":[{"name":"Division of Pediatric Allergy and Pulmonary Medicine Washington University School of Medicine Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases Washington University School of Medicine Saint Louis Missouri USA"},{"name":"Department of Molecular Microbiology Washington University School of Medicine Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Rivera\u2010Spoljaric","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Pulmonary Medicine Washington University School of Medicine Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.85.1.39"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90256-D"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.10.019"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24797"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2017-0106"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0104"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002421"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23716"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24071"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.113.6.1549"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.198"},{"key":"e_1_2_9_14_1","unstructured":"Centers for Disease Control and Prevention (CDC).\u00a02019. Antibiotic resistance threats in the United States 2019. Accessed January 20 2022.https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/2019-ar-threats-report-508.pdf."},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.215"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/7268519"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-009-9207-z"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07890"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03518"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.154.1.8680667"},{"issue":"3","key":"e_1_2_9_21_1","first-page":"CD001021","article-title":"Inhaled anti\u2010pseudomonal antibiotics for long\u2010term therapy in cystic fibrosis","volume":"3","author":"Smith S","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21301"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1086\/314727"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30185-7"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/2047-2994-3-32"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26152","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.26152","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T18:21:13Z","timestamp":1692469273000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,23]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1002\/ppul.26152"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26152","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.164461017.73364147\/v1","asserted-by":"object"}]},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,23]]},"assertion":[{"value":"2022-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}