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Efficacy of Chlorhexidine in Disinfecting Biofilm-Contaminated Tracheostomy Tubes in Various Patient Conditions: A Prospective Observational Study

Year: 2025

Type: article

Abstract: A BSTRACT Background: 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—complex microbial communities embedded in an extracellular polymeric matrix—plays a key role in such infections by shielding pathogens from antibiotics and host defenses. Objective: To evaluate the efficacy of 2% chlorhexidine in eradicating biofilms from tracheostomy tubes compared to normal saline. Methods: 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. Results: Initial biofilm detection confirmed microbial colonization in most samples. After cleaning, Group B showed a significant reduction in biofilm presence ( P < 0.001) compared to Group A. Chlorhexidine was particularly effective against Pseudomonas aeruginosa and Klebsiella pneumoniae . Clinical outcomes, including early decannulation and reduction in secretion thickness and granulation tissue, were superior in Group B. Conclusion: 2% chlorhexidine is significantly more effective than normal saline in reducing biofilm formation on tracheostomy tubes, improving local infection control and patient recovery outcomes.

Source: Journal of Pharmacy And Bioallied Sciences

DOI: 10.4103/jpbs.jpbs_1705_25

Authors: Karkuvelraj Singaravel, C. R. K. Balaji, Sivaranjani Marimuthu, Anand Sundaraman, Panneerselvam Periasamy

Institution: SRM Medical College Hospital and Research Centre

Language: English

Topic: Tracheal and airway disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $250