Caseng Zhang

Supervisor: Elizabeth Hicks

Project: A time-lapse study of the bacteria that colonize the airways of children with tracheostomies


Calgary, AB

Degree program:

Bachelor of Health Sciences, McMaster

What do you get to work on throughout your studentship? 

My summer studentship has focused on cleaning and analyzing a large database with seven years of microbial culture results from pediatric tracheostomy patients. I am currently running different models to describe this data and identify trends, as well as preparing a manuscript for submission to Pediatric Pulmonology.

What's been the best part of your experience so far?

Gaining extensive knowledge and experience in statistical analysis and processing. It has been challenging, but it is exciting to gain a new transferable skill that I can use for future research projects and see trends emerge from the data.

What impact do you hope this project makes once completed? How will this contribute to improving the health of children?

I hope that this project will help to better inform pediatricians about what to expect for children with tracheostomy, especially linking different profiles with their underlying demographics. I hope that this information will inform clinical care and practice for clinicians managing pediatric patients with tracheostomies. With a better understanding of how bacterial colonization evolves and some of the risk factors for more clinically problematic species, there is a chance that clinicians can develop protocols to identify patients who need specific interventions, improving health outcomes of children with tracheostomies.

What interested you in the WCHRI Summer Studentship Program?

My passion for research has always stemmed from my interest in pediatrics. I loved the strong focus on pediatrics in this Summer Studentship Program, as I felt that it would provide me with the best opportunity to further facilitate my research experience in this field. The WCHRI application helped me think through how my project would further my learning as well as give me an opportunity to participate in original research, and I think that specifically helped me set learning goals that provide me with long-term skills.

What's one piece of advice you received from your supervisor/mentor that resonated with you?

My supervisor told me that as someone who is striving to be a clinician-researcher, a big part of what I am developing is my ability to assess what needs to be done and to triage my work when I get busy. This advice has really helped me balance my work and has allowed me to be a much more productive researcher.

Lay abstract:

Tracheostomy is a common procedure performed in critically ill patients who need long-term mechanical ventilation for respiratory failure or to bypass blockages in the airway. Tracheostomy inserts a plastic breathing tube into a patient's neck, where it can be securely fastened in place and is easy to access for ventilator attachment and regular care. A common complication of tracheostomies is that they allow bacteria to colonize the airways and lungs. These bacteria can contribute to infections in these fragile patients. This project will look at 113 children who received a tracheostomy at the Stollery Children's Hospital between 2012 to 2017 and analyze the types of bacteria that colonized their tracheostomy tubes and airways.

We used existing information about the patients to examine lower airway cultures taken from their tracheostomies and identify patterns of how bacteria colonize their lungs. This included determining if the reason for tracheostomy or feeding method may influence what species of bacteria colonize their lungs. Additionally, we aim to understand whether the presence of some bacterial species increases the risk of later colonization of other types of bacteria, which may increase the risk of severe infection or long-term lung damage.

By identifying and understanding trends in how bacteria colonize children's lungs, we hope to improve preventive care and treatment strategies and protocols in caring for this high-risk pediatric population.