Bacterial profile and biofilm intensity on endotracheal tubes following chlorhexidine use in critically ill patients.

Objective: To identify bacterial species colonizing the endotracheal tube (ETT) and to evaluate the extent of biofilm formation in patients undergoing oral hygiene protocols with 0.2% chlorhexidine. In addition, the study aimed to determine the correlation between the duration of ETT placement and t...

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Publicado en:Critical Care & Shock Vol. 28; no. 5; pp. 207 - 215
Autores principales: Rizkiya, Putri, Semedi, Bambang Pujo, Kusuma, Edward, Widodo, Agung Dwi Wahyu
Formato: research tables/charts Journal Article
Publicado: Critical Care & Shock Journal 2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2025
      vid: 28
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      pub: Critical Care & Shock Journal
      place: Houston, Texas
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        atl: Bacterial profile and biofilm intensity on endotracheal tubes following chlorhexidine use in critically ill patients.
      aug:
        au:
          Rizkiya, Putri
          Semedi, Bambang Pujo
          Kusuma, Edward
          Widodo, Agung Dwi Wahyu
        affil: Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
      sug:
        subj:
          Bacterial Colonization
          Endotracheal Tubes
          Biofilms
          Chlorhexidine Therapeutic Use
          Oral Hygiene
          Critically Ill Patients
          Human
          Indonesia
          Female
          Male
          Nonexperimental Studies
          Analytic Research
          Intensive Care Units
          Microbiological Techniques
          Enzyme-Linked Immunosorbent Assay
          Culture Media
          Staining and Labeling
          Gram-Negative Bacteria
          Klebsiella
          Pseudomonas
          Acinetobacter Infections
          Staphylococcus
          Fisher's Exact Test
          Data Analysis Software
          Descriptive Statistics
          Pneumonia, Ventilator-Associated
          Female
          Male
      ab: Objective: To identify bacterial species colonizing the endotracheal tube (ETT) and to evaluate the extent of biofilm formation in patients undergoing oral hygiene protocols with 0.2% chlorhexidine. In addition, the study aimed to determine the correlation between the duration of ETT placement and the degree of bacterial biofilm formation. Design: Observational analytic study. Setting: Intensive Care Unit (ICU) of Dr. Soetomo General Hospital, Surabaya, Indonesia. Patients and participants: Endotracheal tubes were collected from 41 mechanically ventilated ICU patients who had undergone routine oral hygiene with 0.2% chlorhexidine. Patients were selected consecutively, and all ETTs were processed for microbiological analysis with the roll-plate culture method and the enzyme-linked immunosorbent assay (ELISA) biofilm microplate reader. Interventions: There was no additional therapeutic intervention beyond standard ICU care, including ventilator-associated pneumonia (VAP) bundles and chlorhexidine-based oral hygiene every 8 hours. Measurements and results: A total of 67 bacterial isolates were obtained from the oral-exposed surface of ETTs. Among these, 85% (59 isolates) demonstrated biofilm-forming capability, with Klebsiella pneumoniae (33%), Pseudomonas aeruginosa (21%), and Acinetobacter baumannii (10%) being the most common species. Gram-negative bacteria formed the majority of biofilm-positive isolates and exhibited stronger biofilm intensity compared to Gram-positive bacteria. No statistically significant correlation was observed between ETT usage duration and biofilm intensity (p>0.05). Conclusions: High rates of biofilm formation were identified on the outer surfaces of ETTs in ICU patients despite routine chlorhexidine oral care. No significant association was observed between the duration of ETT use and biofilm intensity. These findings highlight the need for additional preventive strategies beyond chlorhexidine to reduce the risk of biofilm-associated complications in mechanically ventilated patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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