title: Staphylococcus aureus biofilm formation on an explanted cochlear implant demonstrated using an ultrasonication technique.
abstract: CONCLUSIONS
  Biofilm forming microorganisms are responsible for the infection of a number of different indwelling medical devices including cochlear implants. The current definitive technique for proving biofilm infection is the use of scanning electron microscopy that is expensive and of limited availability.
  
  
  METHODS
  A persistently infected cochlear implant was explanted. At operation it was surrounded by a fibrous capsule containing a glue-like substance, characteristic of biofilm formation that yielded Staphylococcus aureus after ultrasonication of the device.
  
  
  METHODS
  The explanted cochlear implant was placed in a nutrient broth in an ultrasonic water bath. The implant was ultrasonicated for 5 minutes and the broth cultured on blood agar, incubated aerobically and anaerobically for 48 hours, and then incubated in air on Maconkey agar for 24 hours. This produced a heavy, confluent growth of S. aureus, in contrast to previous aspirates from a blister that lay over the infected implant that grew a coliform organism and Pseudomonas sp.
  
  
  CONCLUSIONS
  Ultrasonication is a widely available and relatively inexpensive technique that can be used to improve the recovery of biofilm-associated organisms from explanted cochlear implants.
authors.affiliation: Department of Otolaryngology, Glan Clwyd Hospital, Rhyl, UK. samfishpool@gmail.com
authors.forename: Samuel Jc
authors.initials: SJ
authors.lastname: Fishpool
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Osborne
authors.forename: Nicholas
authors.initials: N
authors.lastname: Looker
mesh_terms: D001431:Bacteriological Techniques; D018441:Biofilms; D002908:Chronic Disease; D003054:Cochlear Implants / Q000382:microbiology*; D020878:Device Removal; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000601:surgery; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D013010:Sonication; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000601:surgery; D013211:Staphylococcus aureus / Q000502:physiology*; D014057:Tomography, X-Ray Computed