title: Efficacy of disinfecting solutions in removing biofilms from polyvinyl chloride tracheostomy tubes.
abstract: OBJECTIVE
  Bacterial biofilms are prevalent in pediatric tracheostomy tubes (TTs) and are not completely cleared by standard cleaning with gauze and household detergents. We aimed to examine the effectiveness of different disinfecting solutions to remove Staphylococcus aureus (SA) and Pseudomonas aerginosa (PA) biofilms from TTs.
  
  
  METHODS
  Prospective, controlled, in vitro microbiologic study.
  
  
  METHODS
  Uniform coupons obtained from polyvinyl chloride (PVC) pediatric TTs were briefly exposed to human plasma. The samples were incubated in growth media with either PA or SA for 7 days, and total bacterial growth was monitored by media turbidity. Five sets of 18 coupons each were exposed for 5 minutes to one of five different solutions: 2% aqueous chlorhexidine gluconate solution, 0.3% aqueous sodium hypochlorite, Polident denture cleanser, 3% hydrogen peroxide, or preservative-free phosphate-buffered saline (PBS) as a negative control. Biofilm presence was measured with bacterial counts, and surface integrity was assessed with scanning electron microscopy (SEM).
  
  
  RESULTS
  All treatments significantly reduced mean SA counts (P = <.001). Sodium hypochlorite and chlorhexidine were more effective than peroxide and Polident. Chlorhexidine, sodium hypochlorite, and peroxide reduced PA counts (P = .001, .001, and .002, respectively), but Polident tabs had no significant effect. SEM revealed preserved TT surface integrity after exposure to all solutions.
  
  
  CONCLUSIONS
  Disinfection with sodium hypochlorite or chlorhexidine solutions significantly reduces SA and PA biofilms on PVC TTs. Standard home care of reusable pediatric TTs may be improved by use of these readily available solutions.
authors.affiliation: Department of Otolaryngology, University of Florida, Gainesville, Florida 32610, USA. rodrigo.silva@ent.ufl.edu
authors.forename: Rodrigo C
authors.initials: RC
authors.lastname: Silva
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Carver
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 / Q000187:drug effects*; D015169:Colony Count, Microbial; D004202:Disinfectants / Q000494:pharmacology*; D004866:Equipment Contamination; D006801:Humans; D008855:Microscopy, Electron, Scanning; D011143:Polyvinyl Chloride; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000254:growth & development; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D014139:Tracheostomy / Q000295:instrumentation*
chemical_list: D004202:Disinfectants; D011143:Polyvinyl Chloride