Assessment of microbial contamination of tracheobronchial tree in patients with cicatrical stenosis of trachea

Abstract

Cicatricial tracheal stenosis is an urgent matter in thoracic surgery and otolaryngology. The main causes of cicatricial stenosis of the trachea is orotracheal intubation, tracheostomy and neck injuries with damage to the trachea. One of the factors that complicate this disease course is addition of nosocomial infection. We conducted a retrospective study of medical records of 33 patients treated in the thoracic surgery department of Irkutsk Regional Clinical Hospital diagnosed with cicatricial stenosis of trachea for the period from 2011 to 2013. 75 % of patients with cicatricial stenosis of trachea were men of working age up to 50 years old. We evaluated the results of bacteriological examination of detachable tracheobronchial tree. The bacteriological examination of the patients with cicatricial stenosis of trachea often exhibited hospital microflora in the form of Pseudomonas aeruginosa, Streptococcus viridans, Staphylococcus aureus. Associations of microorganisms represent this microflora in 84.4 %. During the antibiotic sensitivity examination, the low effectiveness of commonly used antimicrobials was revealed. The choices in treatment of the patients with cicatricial stenosis of trachea are: colistin, polimeksin, imipenem, meropenem, vancomycin, sulperazon. These results indicate that microbiological monitoring is necessary to detect major pathogens and their antibiotic resistance level at cicatricial stenosis of the trachea.