Treatment of infections associated with medical devices is often frustrated by the inability of antibiotics to penetrate biofilms and the increasing resistance of microbes to antibiotics [4]. In unpublished studies, we have identified bacterial colonization of 106 colony forming units (cfu)/ml on cuffed CH5183284 research buy tracheotomy tubes after 3 days of use. Silver tracheotomy tubes with inherent antimicrobial properties previously
used in patients with a permanent tracheostomy have been replaced with polymer tracheotomy tubes which have improved patient selleck inhibitor comfort. With the increasing use of un-cuffed polymer tracheotomy tubes, monitoring of biofilm formation has become important and regular reprocessing of the un-cuffed tracheotomy tube 1 to 2 times a day is usually recommended by the manufacturer in order to avoid infections. In order to lengthen medical device usage and to improve patient safety
with higher quality polymer tracheotomy tubes, coating with an antimicrobial agent has been suggested [5]. Octenidine-dihydrochloride (OCT) could represent a candidate compound since it has a broad-spectrum antimicrobial activity and low toxicity. Studies on resident skin flora have demonstrated the bactericidal and fungicidal efficiency of OCT [6]. The aim of this study was therefore to develop an OCT coated tracheotomy tube in cooperation with the Heimomed Company and to investigate the antimicrobial inhibitory effect of coated OCT on experimental biofilms formed by S. aureus and P. aeruginosa in-vitro. The OCT coating was then tested for resistance to the tube reprocessing PSI-7977 nmr procedures of brushing, rinsing and disinfection with glutaraldehyde. Results Significant differences in bacterial contamination were observed between uncoated and OCT coated tracheotomy tubes (see “”Additional file 1). Contamination with S. aureus Contamination with S. aureus showed the mean concentration of 103 cfu/ml on OCT coated tracheotomy tubes (group A) was significantly lower compared
to uncoated tubes (105 cfu/ml; group B; P = 0.045). Rolziracetam After five rounds of chemical reprocessing, a hundred fold difference between the colonization of both tube groups (group A = 104 cfu/ml; group B = 106 cfu/ml; P = 0.011) was observed. Following five further procedures of chemical and mechanical reprocessing, recontamination with S. aureus led to the similar colonization of both tube types (per Group: A+B = 106 cfu/ml; P = 0.115). These results are illustrated graphically in Figure 1. Figure 1 Comparison of S. aureus colonization on OCT coated versus uncoated tracheostomy tubes. Mean cfu concentration [log-] after standardized contamination with S. aureus before any reprocessing [T1], after 5 rounds of reprocessing [T2] and an additional 5 reprocessing procedures [T3].