Microbiological evaluation of different reprocessing methods for cuffed and un-cuffed tracheostomy tubes in home-care and hospital setting Mikrobiologische Evaluation unterschiedlicher Aufbereitungsverfahren von blockierbaren und nicht-blockierbaren Tracheostomiekanülen in häuslicher Umgebung und in einer Gesundheitseinrichtung

Background: Manufacturers’ recommendations on cleaning of tracheostomy tubes focus on general warning information and nonMatthias Leonhard Ojan Assadian specific manual cleaning procedures. The aim of this experimental study Michaela Zumtobel was to evaluate different reprocessing methods and to determine the Berit Schneider-Stickler mechanical integrity and functionality of tracheostomy tubes following reprocessing. Methods: Sixteen cuffed or un-cuffed tracheostomy tubes obtained from hospital in-patients were reprocessed using one of the following repro1 Department of Otorhinolaryngology, Medical University of Vienna, Austria cessing methods: a) manual brushing and rinsing with tap water, b) manual brushing followed by disinfection with a glutaraldehyde solution, c) manual brushing followed machine-based cleaning in a dishwasher, and d) manual brushing followed by ultrasound cleaning 2 Institute for Skin Integrity and Infection Prevention, in a commercially available ultrasound device. Microbial burden of the University of Huddersfield, United Kingdom tubes before and after reprocessing was assessed by measurement of microbial colony-forming units per mL (CFU/mL) of rinsing fluid. After cleaning, tracheostomy tubes were investigated for loss of functionality. Findings:Manual brushing and rinsing with tap water reducedmicrobial colonization in average by 10 CFU/mL, but with poor reproducibility and reliability. Complete microbial reduction was achieved only with additional chemical or machine-based thermal disinfection. Ultrasound sonification yielded no furthermicrobial reduction aftermanual brushing. Conclusion:Manual brushing alone will not result in complete eradication of microorganism colonising cuffed or un-cuffed tracheostomy tubes. However, manual cleaning followed by chemical or thermal disinfection may be regarded as safe and reproducible reprocessing method. If a machine-based reprocessing method is used for cuffed tubes, the cuffs’ ventilation hose must be secured in a safe position prior to thermal disinfection.