{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:52:20Z","timestamp":1791294740971,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tracheostomy\u2010dependent children (TDC) experience chronic airway instrumentation and frequent healthcare exposure, increasing their risk for colonization and infection with multidrug\u2010resistant organisms (MDROs). Most TDC reside either in the community or in healthcare facilities, yet the impact of residential setting on airway microbiology in these children is not well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective chart review of TDC\u2009\u2264\u200918 years admitted to an academic tertiary pediatric intensive care unit (PICU) between Jan 2017 and Dec 2022 who underwent tracheal aspirate cultures (TACs) within 72\u2009h of admission. Airway microbiology and MDRO prevalence were compared between children presenting from healthcare facilities and the community. Multivariate mixed\u2010effect logistic regression models evaluated factors associated with MDRO isolation, adjusting for age, number of admissions, and cuffed tracheostomy status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 109 children (282 admissions; 207 community, 75 facility), facility residence was associated with higher odds of isolating any MDROs in bivariate analysis (OR 2.73 95% CI 1.19\u20136.25\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017). In multivariate analysis, \u2265\u20095 prior hospital admissions and cuffed tracheostomy remained independently associated with MDRO isolation. Although facility residence no longer retained statistical significance after adjustment, the adjusted odds ratio remained similar to the bivariate estimate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Healthcare facility residence is associated with increased MDRO isolation. Cumulative healthcare exposure and cuffed tracheostomy status may also be important risk factors for MDRO presence. Respiratory microbiology differs between facility\u2010 and community\u2010based TDC. Awareness of local airway microbiologic patterns and cumulative healthcare exposure may improve interpretation of TACs and guide empiric antimicrobial therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71847","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:37:32Z","timestamp":1790163452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Residence\u2010Associated Differences in Airway Microbiology Among Tracheostomy\u2010Dependent Children"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2692-617X","authenticated-orcid":false,"given":"Elia D.","family":"Rackovsky","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons Division of Pediatric Critical Care, Harlem Hospital Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7855-8319","authenticated-orcid":false,"given":"Marley","family":"Cutrona","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-141X","authenticated-orcid":false,"given":"Monica L.","family":"Koncicki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Albert Einstein College of Medicine Division of Pediatric Critical Care Medicine, Children's Hospital at Montefiore Einstein  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5172-3036","authenticated-orcid":false,"given":"Brenda I.","family":"Anosike","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Albert Einstein College of Medicine Division of Pediatric Infectious Diseases, Children's Hospital at Montefiore Einstein  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-5790","authenticated-orcid":false,"given":"Ilir","family":"Agalliu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-7667","authenticated-orcid":false,"given":"Michelle M.","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Albert Einstein College of Medicine Division of Pediatric Critical Care Medicine, Children's Hospital at Montefiore Einstein  Bronx New York 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