Microbial Flora of Cochlear Implants by Gene Pyrosequencing

Abstract

To describe the microbial flora associated with cochlear implants (CIs) removed for infectious and noninfectious indications. Prospective, controlled. Academic, tertiary medical center. All patients undergoing CI removal. CIs were removed with aseptic technique and processed for microbial identification. CI microbes were identified with routine culture and speciation and 16s deoxyribonucleic acid 454-pyrosequencing. All CIs had evidence of microbes. Propionibacterium acnes and Acidovorax facilis were more common on noninfected CIs (p = 0.005, 0.031). Staphylococcus aureus was more common on infected CIs (p = 0.003). The microbial profiles associated with CI infection were different from, but overlapped with those of noninfected CIs. Microbial culture with selective media identified pathogens not identified on pyrosequencing. Bacteria are present on all CIs, both with and without evidence of clinical infection, but species differ with clinical status. Empiric therapy for CI infections should include coverage for S. aureus. Gene pyrosequencing and selective culture techniques may yield complementary results that may impact the management of CI infections.