{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:30:39Z","timestamp":1786649439155,"version":"build-2736575974"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n Tracheostomy facilitates airway access by creating a stoma in the anterior tracheal wall but predisposes patients to recurrent respiratory infections. Biofilm formation on tracheostomy tubes\u2014complex microbial communities embedded in an extracellular polymeric matrix\u2014plays a key role in such infections by shielding pathogens from antibiotics and host defenses.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To evaluate the efficacy of 2% chlorhexidine in eradicating biofilms from tracheostomy tubes compared to normal saline.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A prospective observational study was conducted over 18 months in the Department of ENT, SRM Medical College Hospital and Research Centre, involving 68 patients with double-lumen tracheostomy tubes. After seven days of tube insertion, inner cannulas were tested for biofilm formation. Biofilm-positive cases were randomized into two groups: Group A (cleaned with normal saline) and Group B (cleaned with 2% chlorhexidine). After seven days, tubes were reassessed for biofilm presence and patient outcomes including secretion type, granulation, and decannulation were recorded.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Initial biofilm detection confirmed microbial colonization in most samples. After cleaning, Group B showed a significant reduction in biofilm presence (\n P<\/jats:italic>\n < 0.001) compared to Group A. Chlorhexidine was particularly effective against\n Pseudomonas aeruginosa<\/jats:italic>\n and\n Klebsiella pneumoniae<\/jats:italic>\n . Clinical outcomes, including early decannulation and reduction in secretion thickness and granulation tissue, were superior in Group B.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n 2% chlorhexidine is significantly more effective than normal saline in reducing biofilm formation on tracheostomy tubes, improving local infection control and patient recovery outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_1705_25","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T17:00:31Z","timestamp":1766422831000},"page":"211-213","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Chlorhexidine in Disinfecting Biofilm-Contaminated Tracheostomy Tubes in Various Patient Conditions: A Prospective Observational Study"],"prefix":"10.4103","volume":"17","author":[{"given":"Karkuvelraj","family":"Singaravel","sequence":"first","affiliation":[{"name":"Department of ENT, Head and Neck Surgery, SRM Medical College Hospital and Research Centre, Kancheepuram, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. R. K.","family":"Balaji","sequence":"additional","affiliation":[{"name":"Department of ENT, SRM Medical College Hospital and Research Centre, Kancheepuram, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivaranjani","family":"Marimuthu","sequence":"additional","affiliation":[{"name":"Department of ENT, SRM Medical College Hospital and Research Centre, Kancheepuram, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Sundaraman","sequence":"additional","affiliation":[{"name":"Department of ENT, SRM Medical College Hospital and Research Centre, Kancheepuram, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panneerselvam","family":"Periasamy","sequence":"additional","affiliation":[{"name":"Department of Physiology, Government Erode Medical College, Erode, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"R1-20251223","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/bja\/aeu440","article-title":"Effect of early tracheostomy on resource utilization and clinical outcomes in critically ill patients: Meta-analysis of RCTs","volume":"114","author":"Szakmany","year":"2015","journal-title":"Br J Anaesth"},{"key":"R2-20251223","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1146\/annurev-med-042711-140023","article-title":"Staphylococcal infections: Mechanisms of biofilm maturation and detachment as critical determinants of pathogenicity","volume":"64","author":"Otto","year":"2013","journal-title":"Annu Rev Med"},{"key":"R3-20251223","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1128\/MMBR.62.4.1244-1263.1998","article-title":"Life below the gum line: Pathogenic mechanisms of Porphyromonas gingivalis","volume":"62","author":"Lamont","year":"1998","journal-title":"Microbiol Mol Biol Rev"},{"key":"R4-20251223","first-page":"e01162","article-title":"Mechanisms of increased resistance to chlorhexidine and cross-resistance to colistin following exposure of Klebsiella pneumoniae","volume":"61","author":"Wand","year":"2016","journal-title":"Antimicrob Agents Chemother"},{"key":"R5-20251223","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1002\/lary.20249","article-title":"Characterization of bacterial biofilms on tracheostomy tubes","volume":"119","author":"Solomon","year":"2009","journal-title":"Laryngoscope"},{"key":"R6-20251223","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1177\/014556130208100915","article-title":"Biofilm formation on tracheostomy tubes","volume":"81","author":"Jarrett","year":"2002","journal-title":"Ear Nose Throat J"},{"key":"R7-20251223","doi-asserted-by":"crossref","first-page":"102491","DOI":"10.1016\/j.amsu.2021.102491","article-title":"Role of chlorhexidine on tracheostomy cannula decontamination in relation to biofilm-forming bacteria: A randomized controlled trial","volume":"67","author":"Hutauruk","year":"2021","journal-title":"Ann Med Surg"}],"container-title":["Journal of Pharmacy and Bioallied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_1705_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:54:10Z","timestamp":1786647250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_1705_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jpbs.jpbs_1705_25","relation":{},"ISSN":["0976-4879","0975-7406"],"issn-type":[{"value":"0976-4879","type":"print"},{"value":"0975-7406","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-11-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}