Bacteraemia following percutaneous dilational tracheostomy

This study reports the incidence of bacteraemia following 106 consecutive bedside percutaneous tracheostomies. Post-tracheostomy blood culture results were compared with other blood cultures from the same population. The incidence of positive post-tracheostomy blood cultures was 10.4% (11/106), compared with 6.6% (7/106) for other blood cultures (odds ratio 1.64, 95% confidence interval 0.61-4.40, P = 0.46). Staphylococcus epidermidis was the most common organism cultured, 7/106 (6.6%) of post-tracheostomy cultures, compared with 3/106 (2.8%) for other cultures (odds ratio 2.43, 95% confidence interval 0.61-9.65, P = 0.33). The other four post-tracheostomy cultures grew an organism cultured from that patient's tracheal secretions. Seventy-four patients were receiving antibiotics at the time of tracheostomy, of these 7 (9.5%) had positive blood cultures, a similar incidence (4 of 32, 12.5%) to those not receiving antibiotics (odds ratio 0.73, 95% confidence interval 0.20-2.70, P = 0.90). We conclude bacteraemia is a common complication of percutaneous tracheostomy; the causative organisms come from the patients' trachea or skin.