Tracheostomy is a commonly performed airway surgery for critically ill patients. Tracheostomy tube is an indwelling prosthesis, providing potential surface for growth of bacteria. Biofilm formation by bacteria as a self-protective mechanism, has led to worrisome antibacterial resistance and thus higher rate of nosocomial infections. A prospective observational study was conducted with a purpose of knowing most common organisms capable of forming biofilm on tracheostomy tube and their antibiotic sensitivity in our setting. Fifty seven percent of the isolates were found to be capable of biofilm production. Acinetobacter baumannii (45%) was the commonest biofilm producer isolated and the commonest multidrug resistant organism (35.7%), followed by Klebsiella pneumoniae (28.5%) . Both biofilm producers and non-biofilm producers were found most susceptible to Amikacin (43%), followed by Gentamicin (30%) and Ciprofloxacin (18.5%). No significant association was found between biofilms and ventilators (p value = 0.558) or pre-existing infection (p value = 0.66) using Chi square test. Potentially biofilm producing bacteria were isolated from tracheostomy tube inner surfaces just after a week of their insertion, in majority of patients. Acinetobacter baumannii and Klebsiella pneumoniae were the commonest biofilm forming organisms and Amikacin, Gentamicin and Ciprofloxacin were most sensitive drugs. Multi drug resistant organisms were also commonly found, stressing the need for sensitivity-based antibiotics. Ventilator usage had no strong association with biofilm formation. Patients with non-infectious conditions also harboured bacteria capable of biofilms in tracheostomy tubes demanding the need for stringent tube hygiene measures and prophylactic antibiotics.

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Introduction: Diabetes mellitus (DM) has a projected rise in its affected population to almost double by the year 2035 in India. Ongoing research regarding its microvascular complications has led to a disparity of opinion about involvement of the audio-vestibular system. Hence to evaluate the audio-vestibular functions in patients with diabetes mellitus and determine their correlation with duration and control of the disease, this study was conducted. Materials & Methods: 97 DM patients were included in this prospective, cross-sectional study and all of them underwent clinical examination, Dix-Hallpike maneuver and investigations like Pure tone audiometry (PTA) and Videonystagmography (VNG). Results: 64 of 97 patients, had varying degrees of sensorineural hearing loss on PTA and 16 patients had vestibular hypofunction noted on caloric test of VNG. It was identified that the occurrence of bilateral hearing loss and vestibular hypofunctioning were statistically significant with chi square test (p value 0.028 and <0.001 respectively), when 5years duration of DM was taken for cut off. Analysis of symptoms with PTA and VNG, found significant correlation of tinnitus and hearing loss (p value 0.03 and <0.001 respectively) with abnormal findings in both the investigations, revealing a subclinical nature of the vestibular dysfunction. However, there were no significant correlations found with the glycaemic control of DM. Conclusions: It is advisable to consider audio-vestibular evaluation with PTA and VNG, as screening tests for long term DM patients with or without symptoms of giddiness and hearing loss as a step for early identification of microvascular complications of the inner ear, though larger studies in other populations needs to be done for further confirmation of the correlation.