Background: Ventilator-associated pneumonia (VAP) is one of the
most common causes of nosocomial infections and is associated with
prolonged hospitalization, increased health care costs, and high
mortality of critically ill patients during hospitalization in intensive
care units (ICUs). Objective: To characterize and evaluate
in vitro and in vivo antimicrobial and anti-biofilm
activity of an in-house tracheostomy tube impregnated with chlorhexidine
and violet crystal. Methods: The tracheostomy tubes were tested
in vitro for their ability to prevent biofilm formation by
standard strains of S. aureus, P. aeruginosa, and E.
coli, and multidrug-resistant bacteria obtained from clinical cultures:
Meticillin-resistant S. aureus (MRSA), and carbapenem-resistant
Acinetobacter baumannii, Pseudomonas aeruginosa and
Klebsiella pneumoniae. Results: The impregnated
tracheostomy tubes demonstrated antimicrobial activity, including for
multidrug-resistant bacteria. In this pilot study, 14 patients were
evaluated, seven in the chlorhexidine and violet crystal-coated group
and seven in the control group. During ventilation, VAP occurred in one
patient in the coated group and in three patients in the control group
(p=0.28). The biomass in the impregnated tubes did not differ from the
control group and no difference was found in the production of sessile
cells by the quantitative method, with a median of 15.50 cfu/mL
(IQR25-75% 12.00-196.50) and 168.00 cfu/mL ((IQR25-75% 78.50-250.00),
respectively. Conclusion: This study provides preliminary
evidence to support that antiseptic impregnation of tracheostomy tube
provides significant antimicrobial activity.