Chemoprophylaxis of Fungal Deterioration of the Provox Silicone Tracheoesophageal Prosthesis in Postlaryngectomy Patients

Vanweissenbruch, R; Bouckaert, Stefan; Remon, Jean Paul; Nelis, Hans; Aerts, R; Albers, F. W. J.

doi:10.1177/000348949710600413

Cited by 51 publications

(41 citation statements)

References 21 publications

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“…26 In contrast, a double-blinded, randomised, controlled trial in 36 patients showed a significant decrease in colonisation of valve prostheses (as assessed by culture density) in patients taking oral miconazole. 27 The effect of prosthesis material upon biofilm adherence has been studied. Prostheses made from silicone and modified with perfluoro alkylsiloxane have been demonstrated to have less biofilm growth than those made from unmodified silicone material.…”

Section: Biofilmsmentioning

confidence: 99%

Biofilms and their role in otorhinolaryngological disease

Macassey

Dawes

2008

J. Laryngol. Otol.

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Virtually all microbes live in biofilm communities. Within these communities, the microbes assume differing specialised roles which confer survival advantages on the community. These communities cause chronic and device-associated infections. Within the specialist field of otorhinolaryngology, biofilms have been shown to play a role in many infections, including: chronic otitis media, cholesteatoma, chronic tonsillitis, chronic sinusitis, and infections of tracheostomies, endotracheal tubes and cochlear implants.

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Section: Biofilmsmentioning

confidence: 99%

Biofilms and their role in otorhinolaryngological disease

Macassey

Dawes

2008

J. Laryngol. Otol.

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“…Especially Candida albicans, Candida tropicalis, and R. dentocariosa are known to reduce the lifetimes of tracheoesophageal shunt prostheses in vivo (5). Antimicrobials or antifungal agents, or both, have been administered to patients in order to eradicate these biofilms (18), but the biofilm offers effective protection against antimicrobials, to which planktonic organisms are usually susceptible (2,7). Therefore, preventive measures seem a better way to deal with these biofilms.…”

mentioning

confidence: 99%

Effects of Quaternary Ammonium Silane Coatings on Mixed Fungal and Bacterial Biofilms on Tracheoesophageal Shunt Prostheses

Oosterhof

Buijssen

Busscher

et al. 2006

Appl Environ Microbiol

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Two quaternary ammonium silanes (QAS) were used to coat silicone rubber tracheoesophageal shunt prostheses, yielding a positively charged surface. One QAS coating [(trimethoxysilyl)-propyldimethyloctadecylammonium chloride] was applied through chemical bonding, while the other coating, Biocidal ZF, was sprayed onto the silicone rubber surface. The sprayed coating lost its stability within an hour, while the chemically bonded coating appeared stable. Upon incubation in an artificial throat model, allowing simultaneous adhesion and growth of yeast and bacteria, all coated prostheses showed significant reductions in the numbers of viable yeast (to 12% to 16%) and bacteria (to 27% to 36%) compared with those for silicone rubber controls, as confirmed using confocal laser scanning microscopy after live/dead staining of the biofilms. In situ hybridization with fluorescently labeled oligonucleotide probes showed that yeasts expressed hyphae on the untreated and Biocidal ZF-coated prostheses but not on the QAS-coated prostheses. Whether this is a result of the positive QAS coating or is due to the reduced number of bacteria is currently unknown. In summary, this is the first report on the inhibitory effects of positively charged coatings on the viability of yeasts and bacteria in mixed biofilms. Although the study initially aimed at reducing voice prosthetic biofilms, its relevance extends to all biomedical and environmental surfaces where mixed biofilms develop and present a problem.Biofilm formation is the leading cause for the failure of biomedical prostheses (9, 13), including tracheoesophageal shunt prostheses, used for speech rehabilitation in patients after total laryngectomy because of a malignant laryngeal tumor. Tracheoesophageal shunt prostheses are made of a silicone rubber (SR) tube capped on one end with a one-way valve and are placed between the esophagus and the trachea. The valve of the prosthesis constitutes its esophageal side, and the one-way mechanism allows air to pass from the tracheal side, but fluids passing the esophagus are blocked from entering the trachea. Microorganisms readily form a biofilm on the esophageal side of a prosthesis, which leads to dysfunction of the valve and induces leakage of fluids in the trachea or increased airflow resistance during speech (3, 15). Consequently, the useful lifetime of a voice prosthesis ranges from 3 to 6 months (10, 15, 16).Tracheoesophageal shunt prosthetic biofilms contain a mixture of yeasts and bacteria, including Candida species, Staphylococcus and Streptococcus species, and Rothia dentocariosa. Especially Candida albicans, Candida tropicalis, and R. dentocariosa are known to reduce the lifetimes of tracheoesophageal shunt prostheses in vivo (5). Antimicrobials or antifungal agents, or both, have been administered to patients in order to eradicate these biofilms (18), but the biofilm offers effective protection against antimicrobials, to which planktonic organisms are usually susceptible (2, 7). Therefore, preventive measures seem a better way to ...

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“…Complete prevention of a bio®lm is likely to be impossible and the ingrowth of the yeasts into the silicone rubber offers a protective environment against any antimicrobial therapy. A slowrelease tablet containing the antimycotic miconazole nitrate has been reported to eliminate candida from within the oropharynx of laryngectomised patients, but signi®cant numbers of yeasts persisted in the bio®lms on the valve side of the prostheses [2]. Similar results were found with the use of amphotericin B lozenges [3,24] and rinsing the oral cavity twice a day with nystatin suspension [25,26].…”

Section: Discussionmentioning

confidence: 72%

“…Indwelling silicone rubber voice prostheses in laryngectomised patients often fail within 3±4 months after insertion due to the formation of a bio®lm on the oesophageal side of the prosthesis causing malfunctioning of the valve mechanism [1,2]. Although the bio®lm consists of various bacterial strains [3±5], including oral streptococci, skin staphylococci and enterococci, it is the yeasts isolated from malfunctioning prostheses which are generally held responsible for failure of the device, as their adhesion is most tenacious [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of probiotic bacteria on prevalence of yeasts in oropharyngeal biofilms on silicone rubber voice prostheses in vitro

Mei¹,

Free

Elving³

et al. 2000

Journal of Medical Microbiology

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The proliferation of yeasts in the mixed bacterial and fungal bio®lms colonising silicone rubber voice prostheses in laryngectomised patients is the main cause of malfunctioning of the valve mechanism on the oesophageal side of the prostheses. Indwelling voice prostheses usually have to be replaced every 3±4 months. The consumption of probiotic bacteria is largely motivated by health claims related to the urogenital and lower digestive tract, but not to the upper digestive tract. The present study examined the in¯uence of probiotic bacteria on the prevalence of yeasts in oropharyngeal bio®lms on silicone rubber voice prostheses, as formed in a modi®ed Robbins device. Exposure of oropharyngeal bio®lms on voice prostheses to suspensions of Bi®dobacterium infantis 420 or Enterococcus faecium 603 did not signi®cantly reduce the number of yeasts in the bio®lm. However, suspensions of Lactobacillus fermentum B54, L. rhamnosus 744 or L. lactis cremoris SK11 led to a reduction in the number of yeasts harvested from the voice prostheses. Suspensions of L. casei Shirota and Streptococcus thermophilus B signi®cantly reduced the number of yeasts in the bio®lm to 39% and 33%, respectively. The reduction brought about in yeast prevalence in the mixed bio®lm was greatest by exposure to a suspension of L. lactis 53, with yeast prevalence only 4% of the control. In conclusion, the study demonstrated that the prevalence of yeasts in oropharyngeal bio®lms on silicone rubber voice prostheses might be controlled by consumption of probiotic bacteria.

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Chemoprophylaxis of Fungal Deterioration of the Provox Silicone Tracheoesophageal Prosthesis in Postlaryngectomy Patients

Cited by 51 publications

References 21 publications

Biofilms and their role in otorhinolaryngological disease

Biofilms and their role in otorhinolaryngological disease

Effects of Quaternary Ammonium Silane Coatings on Mixed Fungal and Bacterial Biofilms on Tracheoesophageal Shunt Prostheses

Effect of probiotic bacteria on prevalence of yeasts in oropharyngeal biofilms on silicone rubber voice prostheses in vitro

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