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European Archives of Oto-Rhino-Laryngology

, Volume 267, Issue 10, pp 1579–1586 | Cite as

Microbial colonization of tracheoesophageal voice prostheses (Provox2) following total laryngectomy

  • Brigita TićacEmail author
  • Robert Tićac
  • Tomislav Rukavina
  • Palmira Gregorović Kesovija
  • Dijana Pedisić
  • Boris Maljevac
  • Radan Starčević
Laryngology

Abstract

The purpose of this study was to determine the presence of individual microorganisms and the most frequent microbial combinations in the biofilm of the indwelling Provox2 voice prosthesis in situ. Furthermore, we wanted to evaluate the possible influence of biofilm composition on the mean and median lifetime of these voice prostheses. Over a 5-year period, implantation of a Provox2 voice prosthesis was performed in 85 patients, or 90% of the overall number of patients who underwent total laryngectomy. In total 100 implanted voice prostheses, at least one of every patient, were microbiologically processed immediately after being replaced. Out of the total of 292 isolates, 67% were bacteria and the remaining 33% were yeasts. The most frequently found yeast species on voice prostheses biofilms was C. albicans, followed by C. krusei and C. tropicalis. The most frequently isolated bacteria included Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, and Streptococcus agalactiae. Simultaneous presence of bacteria and fungi was established in 83% of the processed voice prostheses; in 16% of samples the biofilm contained only one or more bacterial species. The mean time of implantation was 238 days and the median lifetime of the device was 180 days. Dividing the prostheses in four groups according to the composition of biofilm revealed that the device lifetimes varied significantly between groups. The longest lifetime of voice prostheses was associated with the presence of single fungal isolate in combination with bacteria. There is a significant correlation between biofilm composition and the device life time.

Keywords

Microbial colonization Voice prostheses Provox Laryngectomy 

Notes

Acknowledgments

The authors thank Prof. Frans JM Hilgers MD, PhD, for practical and theoretical training, and his critical review of manuscripts. This paper is partially financially supported by research grants 062-0621273-0952 and 062-0621273-0951 of the Ministry of Science, Education and Sport of the Republic of Croatia.

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Brigita Tićac
    • 2
    • 3
    Email author
  • Robert Tićac
    • 1
  • Tomislav Rukavina
    • 2
    • 4
  • Palmira Gregorović Kesovija
    • 2
  • Dijana Pedisić
    • 1
  • Boris Maljevac
    • 1
  • Radan Starčević
    • 1
  1. 1.Clinic of OtorhynolaryngologyClinical Hospital Center RijekaRijekaCroatia
  2. 2.Department of MicrobiologyTeaching Institute of Public HealthRijekaCroatia
  3. 3.Department of Microbiology and Parasitology, Medical FacultyUniversity of RijekaRijekaCroatia
  4. 4.Department of Social Medicine and Epidemiology, Medical FacultyUniversity of RijekaRijekaCroatia

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