ORIGINAL ARTICLE   

Otorinolaringologia 2017 September;67(3):75-80

DOI: 10.23736/S0392-6621.17.02120-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Candida colonization of silicone voice prostheses: evaluation of device lifespan in laryngectomized patients

Calogero GRILLO ¹, Vincenzo SAITA ², Caterina M. GRILLO ², Claudio ANDALORO ³ ✉, Salvatore OLIVERI ⁴, Laura TROVATO ⁴, Ignazio LA MANTIA ³

¹ Department of Medical Sciences, Surgical and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy; ² ENT Unit, Cannizzaro Hospital, Catania, Italy; ³ ENT Unit, Santa Marta e Santa Venera Hospital, Acireale, Catania, Italy; ⁴ Department of Bio-Medical Science, University of Catania, Catania, Italy

BACKGROUND: Purpose of this study was to investigate biofilm formation by yeasts on silicone-rubber voice prostheses in order to evaluate the life-time compared to the species isolated and to the number of organisms grown. Furthermore, Candida albicans germ tube antibody (CAGTA) was detected for discriminating between possible infection and colonization.
METHODS: Over a 5-year period, a laryngectomized group of 28 patients were included in the study and a total of 134 prostheses were subjected to microbial analysis. A CAGTA detection assay was performed too.
RESULTS: Mean prostheses lifespan was 215 days. All voice prostheses were colonized by yeasts, more often with two yeast species. No significant correlation (P=0.081) was seen between the number of yeast species isolated and prosthesis lifespan. The most frequently found yeast species on voice prostheses was C. albicans. Significant correlation (P<0.001) was seen between yeasts grown (CFU/mL) on prosthesis and the life-time. While, no significant correlation (P=0.054) was seen between the number of yeast species isolated and number of CFU/mL grown. The CAGTA titers observed, ranged from <1/20 to 1/320 and only two with positive results.
CONCLUSIONS: This study underline the importance of the leakage of fluids as the main reason for valve insufficiency caused by biofilm formation, a short clinical life-times of voice prostheses not correlated with simultaneous presence of more than one species of yeast but linked to certain biofilm composition. Finally, the CAGTA detection assay is a reliable marker for discriminating between candidiasis infection and colonization.

KEY WORDS: Candida - Larynx, artificial - Laryngectomy