Anaerobic and microaerophilic pathogens in the biofilm formation on voice prostheses: A pilot study†

Objectives/Hypothesis: Voice rehabilitation with voice prostheses is a standard therapy in laryngectomized patients. Biofilm formation on the surface of the voice prostheses causes device failure and requires frequent replacements. Studies analyzing the biofilm of voice prostheses have mainly focused on aerobic bacteria. Anaerobic bacteria as an integral part of the biofilms on voice prostheses have not been investigated yet. Study Design: Prospective pilot study on the occurrence of anaerobic and microaerophilic pathogens in biofilm formation on voice prostheses. Methods: Biofilm samples of 15 voice prostheses were analyzed using a polymerase chain reaction-based hybridization method regarding the presence of 11 selected anaerobic and microaerophilic pathogens. Results: In 80% of the voice prostheses, at least one and up to 10 of the tested bacteria could be identified. Fusobacterium nucleatum was the pathogen most often present (73%). Other frequently occurring pathogens were Treponema denticola (40%), Tannerella forsythia (33%), and Eikenella corrodens (33%). There was no correlation between the number of identified bacteria and the indwelling times (mean, 127 days; maximum, 344 days; minimum, 22 days). Conclusions: For the first time, anaerobic and microaerophilic pathogens have been identified as part of the biofilm formation on the surface of voice prostheses. Those pathogens might be responsible for accelerated biofilm formation and reduced lifetime of the voice prostheses.