The effect of an antimicrobial drain sponge dressing on specific bacterial isolates at tracheostomy sites.

Patients with tracheostomies frequently experience complications, including bacteremia, sepsis, pneumonia, and multi antibiotic-resistant bacterial infections. A prospective, descriptive, randomized, controlled, clinical case series involving seven men and three women was conducted on patients in the neuroscience unit of a long-term rehabilitation hospital during a period of 25 days to compare the use of an nonwoven drain sponge dressing containing an antimicrobial (polyhexamethylene biguanide) to a non-impregnated, nonwoven drain sponge dressing on tracheostomy sites. Specifically, the purpose of the study was to compare the presence of four bacterial pathogens (methicillin-resistant Staphylococcus aureus, Enterobacter cloacae, Pseudomonas aeruginosa, and Staphylococcus aureus) and resident normal skin flora (alpha-hemolytic Streptococci and Staphylococcus epidermidis) at the tracheostomy sites. Culture results for total days of growth showed an absence of pathogens and presence of normal skin flora for 11 study days in patients randomized to the antimicrobial dressing group and an absence of pathogens and presence of normal skin flora for six study days in patients randomized to the control group. The results of this descriptive case series suggest that an antimicrobial drain sponge dressing could be an important adjunct in the control of infections in patients with tracheostomies without compromising normal skin flora.