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wered prospective studies with quantitative cultures could enhance understanding and guide therapy. In children with tracheostomy, the predominant respiratory bacterial pathogens were S. aureus and P.aeruginosa, with MRSA being isolated less frequently than previously described. Multidrug-resistant organisms are isolated more frequently from ventilated children. ETA microbiology is a good screening modality, with negative ETA potentially ruling out lower airway S.aureus and P.aeruginosa. Adequately powered prospective studies with quantit

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