title: Prevention of biofilm formation by dairy products and N-acetylcysteine on voice prostheses in an artificial throat.
abstract: OBJECTIVE
  To evaluate the preventive effect of buttermilk, Yakult Light fermented milk drink and N-acetylcysteine on biofilm formation on voice prostheses in vitro.
  
  
  METHODS
  Groningen button and Provox 2 voice prostheses were inoculated with a mixture of bacteria and yeasts isolated from previously explanted Groningen button voice prostheses. After 5 h, separate throats were flushed with buttermilk, Yakult Light fermented milk drink, N-acetylcysteine or phosphate-buffered saline, which served as a control. After 7 days, the microflora on each voice prosthesis was determined.
  
  
  RESULTS
  On Groningen button voice prostheses, buttermilk, Yakult Light fermented milk drink and N-acetylcysteine all reduced the amount of both bacteria and yeasts. On Provox 2 voice prostheses, buttermilk, Yakult Light fermented milk drink and N-acetylcysteine reduced the amount of bacteria but, conversely, increased the amount of yeasts.
  
  
  CONCLUSIONS
  These in vitro experiments demonstrate that biofilm formation on voice prostheses is reduced in an artificial throat by the use of buttermilk, Yakult Light fermented milk drink and N-acetylcysteine. However, the structural differences between the type of voice prostheses may influence the ultimate effects.
authors.affiliation: Department of Otorhinolaryngology, University Hospital Groningen, The Netherlands. l.q.schwandt@kno.azg.nl
authors.forename: Leonora Q
authors.initials: LQ
authors.lastname: Schwandt
authors.forename: Ranny
authors.initials: R
authors.lastname: Van Weissenbruch
authors.forename: Ietse
authors.initials: I
authors.lastname: Stokroos
authors.forename: Henny C
authors.initials: HC
authors.lastname: Van der Mei
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Busscher
authors.forename: Frans W J
authors.initials: FW
authors.lastname: Albers
mesh_terms: D000111:Acetylcysteine; D001422:Bacterial Adhesion; D018441:Biofilms / Q000254:growth & development*; D002177:Candidiasis / Q000517:prevention & control; D043302:Cultured Milk Products; D005100:Expectorants; D006801:Humans; D007831:Larynx, Artificial / Q000382:microbiology*; D008855:Microscopy, Electron, Scanning; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D013203:Staphylococcal Infections / Q000517:prevention & control; D013290:Streptococcal Infections / Q000517:prevention & control
chemical_list: D005100:Expectorants; D000111:Acetylcysteine