Observational studyCritical care (London, England)2020
Biofilm formation on three different endotracheal tubes: a prospective clinical trial.
Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02284438 (Innovation Against Infection - Device Related Infections - Part ETT), which is not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Innovation Against Infection - Device Related Infections - Part ETT
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Biofilm Formation on Endotracheal and Tracheostomy Tubing: A Systematic Review and Meta-Analysis of Culture Data and Sampling Method.MicrobiologyOpen · 2025Pooled it
- Prevention of ventilator-associated pneumonia by metal-coated endotracheal tubes: a meta-analysis.Critical care (London, England) · 2024Pooled it
- Application of double-sleeve endotracheal tube in infection control for icu patients: a randomized controlled trial.Head & face medicine · 2025Trial
- Tackling Biofilm-Forming Pathogens: A Challenge to Overcome in the Fight Against Infectious Diseases.Pathogens (Basel, Switzerland) · 2026Review
- Article
- Prevalence and Multidrug Resistance of WHO-Priority Bacterial Pathogens in a Romanian Intensive Care Unit.Journal of clinical medicine · 2026Article
- Antimicrobial-coated endotracheal tubes: A narrative review.Journal of critical care · 2026Review
- Biofilm communities above and below the cuff of endotracheal tubes are spatially homogenous.Respiratory research · 2026Observational
- Surfactant-Engineered Niosomal Antibiotic Systems for Biofilm-Associated Infections: Design Principles and Translational Perspectives.International journal of nanomedicine · 2026Review
- 2024 Year in Review: Ventilator-Associated Pneumonia.Respiratory care · 2025Review
- Synergistic Activity of Vancomycin and Gentamicin AgainstMicroorganisms · 2025Article
- Safety and complications of antimicrobial coated compared to conventional intramedullary femoral nails in proximal femoral fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- The role of cyclic di-GMP in biomaterial-associated infections caused by commensal Escherichia coli.PloS one · 2025Article
- Plasma Surface Modification of the Inner Wall of Montgomery's Tracheal Implant (T-Tube).Polymers · 2024Article
- Biofilm Production in Intensive Care Units: Challenges and Implications.Pathogens (Basel, Switzerland) · 2024Review
- Localized delivery of therapeutics impact laryngeal mechanics, local inflammatory response, and respiratory microbiome following upper airway intubation injury in swine.Respiratory research · 2024Article
- Optimizing Diagnosis and Management of Ventilator-Associated Pneumonia: A Systematic Evaluation of Biofilm Detection Methods and Bacterial Colonization on Endotracheal Tubes.Microorganisms · 2024Review
- A new model of endotracheal tube biofilm identifies combinations of matrix-degrading enzymes and antimicrobials able to eradicate biofilms of pathogens that cause ventilator-associated pneumonia.Microbiology (Reading, England) · 2024Article
- Recreating chronic respiratory infectionsEuropean respiratory review : an official journal of the European Respiratory Society · 2024Review
- Prevalence of Infections and Antimicrobial Resistance of ESKAPE Group Bacteria Isolated from Patients Admitted to the Intensive Care Unit of a County Emergency Hospital in Romania.Antibiotics (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBiofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation.
methodsWe compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after > 24 h of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP.
resultsHigh-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14-15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06-0.59], p = 0.005, and OR 0.34 [95% CI 0.13-0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17-1.65], p = 0.278). In 60% of the oropharyngeal cultures and 58% of the endotracheal cultures collected at intubation, the same microorganism was found in the ETT biofilm at extubation. In patients who developed VAP, the causative microbe remained in the biofilm in 56% of cases, despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation.
conclusionHigh-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Further research on methods to prevent, monitor, and manage biofilm occurrence is needed.
trial registrationClinicalTrials.gov NCT02284438 . Retrospectively registered on 21 October 2014.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.