title: Treatment of a cochlear implant biofilm infection: a potential role for alternative antimicrobial agents.
abstract: OBJECTIVE
  This study aimed to investigate antimicrobial treatment of an infected cochlear implant, undertaken in an attempt to salvage the infected device.
  
  
  METHODS
  We used the broth microdilution method to assess the susceptibility of meticillin-sensitive Staphylococcus aureus isolate, cultured from an infected cochlear implant, to common antimicrobial agents as well as to novel agents such as tea tree oil. To better simulate in vivo conditions, where bacteria grow as microcolonies encased in glycocalyx, the bactericidal activity of selected antimicrobial agents against the isolate growing in biofilm were also compared.
  
  
  RESULTS
  When grown planktonically, the S aureus isolate was susceptible to 17 of the 18 antimicrobials tested. However, when grown in biofilm, it was resistant to all conventional antimicrobials. In contrast, 5 per cent tea tree oil completely eradicated the biofilm following exposure for 1 hour.
  
  
  CONCLUSIONS
  Treatment of infected cochlear implants with novel agents such as tea tree oil could significantly improve salvage outcome.
authors.affiliation: Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast Medical Biology Centre, Northern Ireland, UK. aaron.brady@qub.ac.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Brady
authors.forename: T B
authors.initials: TB
authors.lastname: Farnan
authors.forename: J G
authors.initials: JG
authors.lastname: Toner
authors.forename: D F
authors.initials: DF
authors.lastname: Gilpin
authors.forename: M M
authors.initials: MM
authors.lastname: Tunney
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects*; D003054:Cochlear Implants / Q000382:microbiology*; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000502:physiology; D020947:Tea Tree Oil / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D020947:Tea Tree Oil