Nutritional status and bacterial binding in the lower respiratory tract in patients with chronic tracheostomy

M. S. Niederman, W. W. Merrill, R. D. Ferranti, K. M. Pagano, L. B. Palmer, H. Y. Reynolds

Research output: Contribution to journalArticlepeer-review

95 Scopus citations


Patients with chronic tracheostomy often develop tracheobronchial colonization with enteric gram-negative bacilli, especially Pseudomonas aeruginosa, but pathogenic mechanisms are largely unknown. To examine this problem, we measured in-vitro bacterial adherence to airway epithelial cells from the tracheal surfaces of 15 patients with chronic tracheostomy and 18 healthy, noncolonized controls without tracheostomy. Patients with tracheostomy had more tracheal cell adherence (7.3 ± 0.4 [SE] bacteria/cell) than controls (4.8 ± 0.7 bacteria/cell; p = 0.008), but patients colonized by Pseudomonas species had even more binding (9.0 ± 0.06 bacteria/cell) than those without this binding (5.8 ± 0.8 bacteria/cell; p = 0.008). Differences between patients in lower airway cell binding of bacteria were largely related to a multifactorial assessment of patient nutritional status, the prognostic nutritional index (r = 0.67, p = 0.005). Thus, nutritional status may account in part for the common problem of tracheobronchial colonization with gram-negative bacteria in patients with chronic tracheostomy.

Original languageEnglish (US)
Pages (from-to)795-800
Number of pages6
JournalAnnals of internal medicine
Issue number6
StatePublished - 1984

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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