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

DOI: 10.23736/S0392-6621.17.02120-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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

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