title: Lactobacilli: important in biofilm formation on voice prostheses.
abstract: OBJECTIVE
  We sought to identify bacterial strains responsible for biofilm formation on silicone rubber voice prostheses.
  
  
  METHODS
  We conducted an analysis of the bacterial population in biofilms on used silicone rubber voice prostheses by using new microbiological methods.
  
  
  METHODS
  Two microbiological methods were used: polymerase chain reaction-denaturing gradient gel electrophoresis and fluorescence in situ hybridization. Twenty-six Provox2 and eight Groningen Ultra Low Resistance voice prostheses that were removed because of leakage through the prosthesis or because of increased airflow resistance were used in this study.
  
  
  RESULTS
  The results showed that 33 of the 34 explanted voice prosthetic biofilms contained lactobacilli in close association with the Candida sp. present.
  
  
  CONCLUSIONS
  Lactobacilli are general colonizers of tracheoesophageal voice prostheses in vivo, growing intertwined with Candida. This knowledge may be important in the development of new pathways directed to prevent or to influence biofilm formation on tracheoesophageal voice prostheses and elongate their lifespan.
authors.affiliation: Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, Groningen, the Netherlands. k.j.d.a.buijssen@kno.umcg.nl
authors.forename: Kevin J D A
authors.initials: KJ
authors.lastname: Buijssen
authors.forename: Hermie J M
authors.initials: HJ
authors.lastname: Harmsen
authors.forename: Henny C
authors.initials: HC
authors.lastname: van der Mei
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Busscher
authors.forename: Bernard F A M
authors.initials: BF
authors.lastname: van der Laan
mesh_terms: D018441:Biofilms; D002175:Candida / Q000302:isolation & purification / Q000502:physiology; D020878:Device Removal; D004586:Electrophoresis; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007778:Lactobacillus / Q000302:isolation & purification* / Q000502:physiology*; D007831:Larynx, Artificial / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D011475:Prosthesis Failure; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers