Biofilm formation on the Provox ActiValve: Composition and ingrowth analyzed by Illumina paired-end RNA sequencing, fluorescence in situ hybridization, and confocal laser scanning microscopy

Background: The most frequent cause of voice prosthesis failure is microbial biofilm formation on the silicone valve, leading to destruction of the material and transprosthetic leakage. The Provox ActiValve valve is made of fluoroplastic, which should be insusceptible to destruction. Aim: determining if fluoroplastic is insusceptible to destruction by Candida-species.

Methods: 33 dysfunctional Provox ActiValves (collected: 2011-2013). Biofilm-analysis: Illumina paired-end sequencing (IPES); assessment of biofilm-material interaction with fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM).

Results: IPES (n=10): Candida albicans and Candida tropicalis are dominant populations on fluoroplastic and silicone. Microbial diversity is significantly lower on fluoroplastic. L. gasseri is the prevalent bacterial strain on most voice prostheses. FISH and CLSM (n=23): in none of the cases ingrowth of Candida-species in fluoroplastic is present.

Conclusions: Fluoroplastic material of Provox ActiValve appears insusceptible to destruction by Candida-species, which could help improve durability of voice prostheses. This article is protected by copyright. All rights reserved.