Electron microscopic studies of endotracheal tubes used in neonates: do microbes adhere to the polymer?

Fourteen neonates intubated at birth for 1-16 days had a microbiological follow up. After removal, tubes were examined using electron microscopy. Tubes became covered with a slimy accretion from the third day in place, independently of bacterial colonization, which was, in all but one cases, restricted to the rough areas of the tubes. Only Candida albicans and the corresponding slimy coat were found on smooth areas of tube. Cocci were noticed on 3 tubes. They were associated with the slimy accretion. Transmission micrographs elicited a thick material that was lying between cocci and polymer. These results showed that, on neonates' endotracheal tubes, accretion occurred independently of microbial colonization and that when colonization occurred, cocci adhered preferentially to a biological coat of human origin rather than the medical devices.