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Effect of Blood and Mucus on Tympanostomy Tube Biofilm Formation

Authors

  • John Malaty MD,

    1. Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A.
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  • Patrick J. Antonelli MD

    Corresponding author
    1. Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A.
    • Dr. Patrick J. Antonelli, Department of Otolaryngology, University of Florida, Box 100264, 1600 SW Archer Road, Gainesville, FL 32610-0264
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  • Presented at the Southern Section of the Triological Society, Naples, Florida, U.S.A., January 10–12, 2008.

  • This study was funded by the University of Florida Department of Otolaryngology.

Abstract

Objectives/Hypothesis: Tympanostomy tube (TT) biofilm formation may lead to refractory otorrhea and occlusion. The aim of this study was to determine whether TT biofilm formation may be promoted by mucus or blood exposure.

Study Design: In vitro, controlled.

Methods: Fluoroplastic TTs were exposed to blood, mucoid effusion, or saline. Half were allowed to dry. TTs were cultured with Pseudomonas aeruginosa. After 4 days, gentamicin was added to kill planktonic bacteria. Biofilm formation was assessed by quantitative bacterial counts and scanning electron microscopy.

Results: Mucus pretreatment (dry and wet) did not increase biofilm formation. Both dry and wet blood exposure increased biofilm formation by bacterial counts (P < .0001). Biofilm formation was demonstrated by electron microscopy in all groups.

Conclusions:P. aeruginosa biofilm formation on fluoroplastic TTs is enhanced by blood exposure. Care should be taken to minimize bleeding with TT placement to reduce the risk of biofilm formation.

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