Effect of vancomycin-coated tympanostomy tubes on methicillin-resistant Staphylococcus aureus biofilm formation: in vitro study

Background and objective: Bacterial biofilm formation has been implicated in the high incidence of persistent otorrhoea after tympanostomy tube insertion. It has been suggested that the tube material may be an important factor in the persistence of such otorrhoea. Development of methicillin-resistant Staphylococcus aureus otorrhoea after tympanostomy tube placement is a growing concern. We evaluated the effect of using vancomycin and chitosan coated tympanostomy tubes on the incidence of methicillin-resistant Staphylococcus aureus biofilm formation in vitro. Materials and methods: Three sets each of vancomycin-coated silicone tubes (n = 5), commercial silver oxide coated silicone tubes (n = 5) and uncoated tympanostomy tubes (as controls; n = 5) were compared as regards resistance to methicillin-resistant Staphylococcus aureus biofilm formation after in vitro incubation. Results: Scanning electron microscopy showed that the surfaces of the silver oxide coated tubes supported the formation of thick biofilms with crusts, comparable to the appearance of the uncoated tubes. In contrast, the surface of the vancomycin-coated tympanostomy tubes was virtually devoid of methicillin-resistant Staphylococcus aureus biofilm. Conclusion: Vancomycin-coated tympanostomy tubes resist methicillin-resistant Staphylococcus aureus biofilm formation. Pending further study, such tubes show promise in assisting the control of methicillin-resistant Staphylococcus aureus biofilm formation.