title: Biofilm accumulation on endotracheal tubes following prolonged intubation.
abstract: OBJECTIVE
  To demonstrate that patients who have been intubated for prolonged periods of time will have an increased likelihood of developing bacterial biofilm on their endotracheal tubes.
  
  
  METHODS
  We collected endotracheal tubes from patients at the time of extubation, and analysed representative sections with scanning electron microscopy for morphologic evidence of biofilms.
  
  
  RESULTS
  From September 2007 to September 2008, 32 endotracheal tubes were analysed with electron microscopy. Patients who had been intubated for 6 days or longer had a significantly higher percentage of endotracheal tubes that exhibited bacterial biofilms, compared with patients intubated for less than 6 days (88.9 versus 57.1 per cent, p = 0.0439).
  
  
  CONCLUSIONS
  Longer duration of intubation is associated with a higher incidence of bacterial biofilm. Further research is needed to link the presence of bacterial biofilms to acquired laryngotracheal damage.
authors: Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. jonathan.mlee@uphs.upenn.edu
authors: J M
authors: JM
authors: Lee
authors: N
authors: N
authors: Hashmi
authors: J D
authors: JD
authors: Bloom
authors: E
authors: E
authors: Tamashiro
authors: L
authors: L
authors: Doghramji
authors: B
authors: B
authors: Sarani
authors: J N
authors: JN
authors: Palmer
authors: N A
authors: NA
authors: Cohen
authors: N
authors: N
authors: Mirza
mesh_terms: D018441:Biofilms; D004866:Equipment Contamination; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D007820:Laryngeal Mucosa / Q000382:microbiology / Q000473:pathology; D007829:Laryngostenosis / Q000209:etiology / Q000382:microbiology; D008855:Microscopy, Electron, Scanning; D011549:Pseudomonas / Q000302:isolation & purification / Q000502:physiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000502:physiology*; D013997:Time Factors; D014132:Trachea / Q000382:microbiology; D014135:Tracheal Stenosis / Q000209:etiology / Q000382:microbiology