Study Cohort
Among 170 children with BPD and tracheostomies included during the 9-year study period, 2,103 bacterial respiratory cultures were obtained (median 10 cultures per child over their 3 years of enrollment, IQR:3-17, full range 1-45, Table 1 ). Children had a median age at tracheostomy placement of 4.1 months (IQR: 3.2-5.3 months). Children had a median 5 CCCs per child (IQR: 4-6) and 67.6% required baseline chronic ventilator use at some point in their 3 years post-tracheostomy.
Over half (59.4%) of children had any pathogen identified on bacterial isolation on respiratory cultures during the 3-years post-tracheostomy (Table 1, Figure 1 ). Among children with pathogens identified, the median time to first pathogen post-tracheostomy placement was 3.7 months (IQR: 0.9-11.5 months). Among children with any P. aeruginosa , the median time to first P. aeruginosapost-tracheostomy placement was 3.3 months (IQR: 0.8-11.2 months).
Compared with children who never had pathogens identified, children with any pathogen identification were more likely to be privately insured (45.5% vs. 23.2%, p=0.003), but there were no differences in gender, race, or ethnicity. Children with pathogen identification had more CCCs (median 5 CCCs [IQR: 4-6] vs. 4 CCCs [IQR: 3-6], p=0.04) and were also more likely to use a ventilator at baseline (74.3% vs. 58.0%, p=0.03). Children with pathogen identification had approximately three times more cultures collected per child compared with children without pathogen identification (median 12 [IQR: 7-18] vs. 4 [IQR: 2-13], p<0.001).