Solomon Donald H, Wobb Jessica, Buttaro Bettina A, Truant Allan, Soliman Ahmed M S
Department of Otolaryngology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Laryngoscope. 2009 Aug;119(8):1633-8. doi: 10.1002/lary.20249.
OBJECTIVES/HYPOTHESIS: To characterize the structure and microbial content of biofilms found on tracheostomy tubes. To determine the correlation between the patients' clinical condition and biofilm content.
Prospective observational series.
Tracheostomy tubes were collected from patients in both the inpatient and outpatient setting at an urban academic medical center. Sections of the tracheostomy tubes were evaluated by confocal microscopy and bacteria from them plated and identified. The number of colony forming units (CFUs) and species present were determined and a univariate analysis performed to correlate them with various clinical factors.
Bacteria were cultured from 19 of the 21 tracheostomy tubes collected. There were between 1 x 10(6) and 1 x 10(10) CFUs present in each of the 2 mm sections. Twelve different bacterial species and one fungus were isolated from culture and speciation. The number of bacteria isolated and the CFUs calculated varied in tubes obtained from the same patient at different times.
Biofilms were present on tracheostomy tubes in greater than 90% of tracheostomy tubes collected as early as 7 days after insertion in both the inpatients and outpatients. Although a variety of bacteria were identified in the biofilm, they often appeared as discrete microcolonies that appeared to be monospecies biofilm on confocal microscopy. There was a statistically significant inverse correlation between the number of colony forming units found and frequency of inner cannula change.
目的/假设：描述气管造口管上生物膜的结构和微生物成分。确定患者临床状况与生物膜成分之间的相关性。
前瞻性观察系列研究。
从城市学术医疗中心的住院和门诊患者中收集气管造口管。通过共聚焦显微镜对气管造口管切片进行评估，并将其上的细菌进行接种和鉴定。确定菌落形成单位（CFU）数量和存在的菌种，并进行单因素分析以将它们与各种临床因素相关联。
在收集的21根气管造口管中，有19根培养出细菌。每2毫米切片中存在1×10⁶至1×10¹⁰个CFU。从培养物和菌种鉴定中分离出12种不同细菌和1种真菌。在不同时间从同一患者获得的气管造口管中，分离出的细菌数量和计算出的CFU数量有所不同。
在住院患者和门诊患者中，早在气管造口管插入后7天收集的气管造口管中，超过90%存在生物膜。尽管在生物膜中鉴定出多种细菌，但在共聚焦显微镜下它们通常表现为离散的微菌落，似乎是单菌种生物膜。发现的菌落形成单位数量与内套管更换频率之间存在统计学上的显著负相关。
