title: Effectiveness of pediatric tracheostomy tube cleaning.
abstract: OBJECTIVE
  To determine the effectiveness of typical reprocessing of pediatric tracheostomy tubes (TTs) with detergent-soaked gauze pads.
  
  
  METHODS
  In vitro microbiologic study.
  
  
  METHODS
  Department of Otolaryngology, University of Florida, Gainesville.
  
  
  METHODS
  Polyvinyl chloride and silicone TTs of 3 different manufacturers.
  
  
  METHODS
  Thirty TTs were cultured with Pseudomonas aeruginosa or Staphylococcus aureus and reprocessed after 4 days. Eighteen additional TTs were exposed to plasma and then cultured with P aeruginosa or S aureus for 7 days.
  
  
  METHODS
  The presence of biofilms was assessed before and after cleaning by quantitative bacterial counts and scanning electron microscopy.
  
  
  RESULTS
  Bacterial counts that were obtained before cleaning of the tubes did not differ among brands. Reprocessing reduced P aeruginosa and S aureus bacterial counts in the 4-day group (P = .003 and P = .004, respectively), but clean TTs had a mean count of 10(5) colony-forming units/mL. Reprocessing did not significantly reduce S aureus or P aeruginosa bacterial counts in TTs pretreated with plasma and exposed to 7-day culture.
  
  
  CONCLUSIONS
  P aeruginosa and S aureus biofilms in pediatric TTs are not eradicated by standard cleaning methods. Further research is needed to determine the clinical significance of these findings and whether strategies to prevent biofilm formation or more effective disinfection methods would result in improved clinical outcomes.
authors.affiliation: Department of Otolaryngology, University of Florida, Gainesville, FL 32610, USA. rodrigo.silva@ent.ufl.edu
authors.forename: Rodrigo C
authors.initials: RC
authors.lastname: Silva
authors.forename: Carolyn P
authors.initials: CP
authors.lastname: Ojano-Dirain
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Antonelli
mesh_terms: D018441:Biofilms; D002648:Child; D015169:Colony Count, Microbial; D004203:Disinfection / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control*; D006801:Humans; D016014:Linear Models; D008855:Microscopy, Electron, Scanning; D011143:Polyvinyl Chloride; D011550:Pseudomonas aeruginosa; D012828:Silicones; D013211:Staphylococcus aureus; D014139:Tracheostomy / Q000295:instrumentation*
chemical_list: D012828:Silicones; D011143:Polyvinyl Chloride