{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:46:38Z","timestamp":1747172798531,"version":"3.40.5"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24000965_as1\"><jats:title>Objective:<\/jats:title><jats:p>To evaluate the clinical impact and features associated with repeat tracheal aspirate (TA) cultures in children admitted to the intensive care unit.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000965_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000965_as3\"><jats:title>Setting:<\/jats:title><jats:p>A 338-bed freestanding, tertiary pediatric academic medical center with pediatric medical intensive care unit (PICU) and cardiac intensive care units (CICU).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000965_as4\"><jats:title>Patients:<\/jats:title><jats:p>Children \u226418 years of age who were admitted to either the PICU or CICU who had \u22652 TA cultures in a single intensive care admission.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000965_as5\"><jats:title>Methods:<\/jats:title><jats:p>Patients with \u22652 TA cultures between 2018 and 2019 were included in this study. The following information was collected: patient demographics, clinical data summarizing patient condition at the time of culture collection, number of TA cultures per patient, antibiotic usage, and microbiologic data. Descriptive statistics established the frequency of TA collection, time between culturing, clinical reasoning for collection, antibiotic exposure, and development of multidrug-resistant organisms (MDRO).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000965_as6\"><jats:title>Results:<\/jats:title><jats:p>Sixty-three patients had repeat TA cultures and accounted for 252 TA cultures during the study period. Most patients with repeat TA cultures were admitted to the PICU (71%) and were male (65%). A median of 3 TA cultures per patient were obtained with 50% of repeat cultures occurring within 7 days from the previous culture. Sixty-six percent of patients had the same organism cultured on \u22652 TA cultures. Most antibiotics were not modified or continued to treat the results of the TA culture.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000965_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>Repeat TA cultures frequently show the same pathogens, and results do not often influence antibiotic selection or usage. Repeat TA cultures did demonstrate the development of MDROs.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.96","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T10:48:12Z","timestamp":1717152492000},"page":"936-942","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Repeat tracheal aspirate cultures in pediatric intensive care patients: Frequency, resistance, and antimicrobial use"],"prefix":"10.1017","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0503-1734","authenticated-orcid":false,"given":"Edward","family":"Lyon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Goldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3275-6657","authenticated-orcid":false,"given":"Rangaraj","family":"Selvarangan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-7469","authenticated-orcid":false,"given":"Elizabeth","family":"Monsees","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"S0899823X24000965_ref11","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky118"},{"key":"S0899823X24000965_ref31","doi-asserted-by":"crossref","first-page":"e20201634","DOI":"10.1542\/peds.2020-1634","article-title":"Diagnostic stewardship of endotracheal aspirate cultures in a PICU","volume":"147","author":"Sick-Samuels","year":"2021","journal-title":"Pediatrics"},{"key":"S0899823X24000965_ref32","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/PCC.0b013e31828a897f","article-title":"Multidisciplinary quality improvement initiative to reduce ventilator-associated tracheobronchitis in the PICU","volume":"14","author":"Muszynski","year":"2013","journal-title":"Pediatr Crit Care Med"},{"key":"S0899823X24000965_ref2","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1017\/ice.2022.88","article-title":"Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 update","volume":"43","author":"Klompas","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0899823X24000965_ref27","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/PCC.0000000000002761","article-title":"Compliance with an antibiotic guideline for suspected ventilator-associated infection: the Ventilator-Associated INfection (VAIN2) Study","volume":"22","author":"Karsies","year":"2021","journal-title":"Pediatr Crit Care Med"},{"key":"S0899823X24000965_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"S0899823X24000965_ref14","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1164\/rccm.200405-644ST","article-title":"Infectious Diseases Society of A. 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