Examination of Early Endotracheal Aspirate Cultures in Children with Acute Respiratory Failure Due to Presumed Acute Respiratory Tract Infection

OBJECTIVE: To determine the yield of early endotracheal aspirate cultures in mechanically ventilated pediatric patients with acute respiratory failure due to acute respiratory tract infection and endeavor to guide antibiotic choice in acute respiratory failure with concern for infectious etiology. RESULTS: One-hundred ten admissions were included. Of those samples, 61 percent (67 out of 110) had bacterial growth in tracheal aspirate samples. Ninety percent (99 out of 110) patients have received antibiotics and in 47 percent (53 out of 110) antibiotics were optimized or discontinued according to the culture results. There were no difference in duration of mechanical ventilation or PICU stay in patients with positive versus negative cultures (p: 0.613, P: 0.337). CONCLUSIONS: Our study shows a high yield of positive tracheal aspirate cultures in infants, children and adolescents with acute respiratory failure. The cultures identify common organisms, helps to guide initial antibiotics choice, as well as later optimization or antibiotic discontinuation.