Background: Tracheobronchial foreign body aspiration (TFBA) is a major cause of death in children. There are few reports about lower respiratory tract infection (LRTI) caused by TFBA. This study collected the TFBA in our hospital to analyze the LRTI and to determine its risk factors. Methods: A total of 194 children who were performed TFBA extraction in The Children’s Hospital of Zhejiang University School of Medicine between June 2019 and April 2020 were enrolled. The clinical data, cervicothoracic CT and operation records were collected. Chi-square test, rank sum test and multivariate logistics regression analysis were applied. Results: The incidence of LRTI was 46.6%, 68.6% and 68.6% respectively when retention time was within 24 hours, 1 week and more than 1 week. Cervicothoracic CT showed embedding site in and above trachea in 24 cases, in main bronchus in 134 cases, in segmental bronchus and below in 36 cases. Cervicothoracic CT showed no obvious abnormality in 60 cases, obstructive emphysema or atelectasis in 77 cases, obstructive pneumonia in 50 cases, and the rest in 7 cases. Cervicothoracic CT diagnosis and retention time of TFBA were different between LRTI group and non-LRTI group in univariate analysis. There was a correlation between the retention time of TFBA and LRTI in multivariate logistics regression analysis. Conclusionss: The incidence of LRTI caused by TFBA is high. There was no difference in the incidence of LRTI between organic and inorganic TFBA. The retention time of TFBA is an independent risk factor for LRTI.

Objectives: Tracheobronchial foreign body aspiration (TFBA) is a major cause of accidental death in children. Lower respiratory tract infection (LRTI) may be caused by TFBA, but there are few reports about LRTI associated with TFBA. This study collected TFBA cases in our hospital to analyze LRTI and determine its risk factors. Methods: A total of 194 children who underwent tracheobronchial foreign body (TFB) extraction in The Children’s Hospital of Zhejiang University School of Medicine from June 2019 to April 2020 were enrolled. CT chest is routinely used in the workup of suspected airway FB at our institution to evaluate for patients, a FB was already highly suspected. The retention time was defined as from the time of TFB inhalation or presentation (if there was no history of TFBA) to the time of TFB removal. General characteristics including weight, clinical symptoms, operative records, cervicothoracic CT, retention time, type of TFB and postoperative hospitalization time were collected. Chi-square tests, rank sum tests and multivariate logistic regression analyses were performed. Results: The incidence of LRTI was 46.6%, 68.6%, and 68.6% when the retention time was within 24 hours, between 24 hours and up to 1 week and more than 1 week, respectively. Postoperative hospitalization time of LRTI group was significantly longer than that of non-LRTI group. Findings for cervicothoracic CT as pneumonia, emphysema, atelectasis meant more serious clinical manifestations and the retention time was longer in the LRTI group than in the non-LRTI group. There was a positive correlation between the retention time of a TFB and LRTI in multivariate logistic regression analysis. Conclusions: The incidence of LRTI caused by TFBA is high. LRTI is association with longer postoperative hospitalization time. The TFB retention time is an independent risk factor for LRTI. If a patient presents with significant LRTI symptoms, a course of steroids and antibiotics maybe a safer approach rather than proceeding immediately with bronchoscopic removal.