Fluorescence in situ hybridization and microbial community profiling analysis of explanted cochlear implants

Leena Asfour, Daniel Smyth, Cynthia B. Whitchurch, Rosalia Cavaliere, J. Thomas Roland

Research output: Contribution to journalArticlepeer-review


Background: Cochlear implant (CI) infections affect a small, but significant number of patients. Unremitting infections can lead to explantation. Fluorescence in situ hybridization (FISH) and microbial community profiling (MCP) are methods of studying microbial environments of explanted devices that can provide information to reduce morbidity and costs of infected CIs. Aims/objectives: To describe the results and clinical significance of bacterial analyses conducted on explanted CIs. Material and methods: Between 2013 and 2017, 12 explanted devices underwent microbiological analysis in addition to the manufacturer’s device failure analysis. Patients’ clinical history, infection status and outcome were reviewed and correlated with microbial analysis results. Results: From 2013 to 2017, 12 Cochlear™ devices from 11 patients underwent additional MCP or FISH analysis. Five devices were explanted due to suspected implant associated infection, and seven were explanted for other reasons. FISH analysis revealed biofilm presence on all infected devices, only partial correlation of cultures with biofilm composition and confirmation that biofilm formation occurs preferentially at particular device interfaces and geometries. MCP analysis presented challenges in data analysis inherent to its technique but correlated with cultures of infected devices and suggested a diverse microbial composition of explanted devices. Conclusions and significance: Microbial analysis of explanted devices can aid in further elucidating treatment approaches to infected CIs.

Original languageEnglish
Pages (from-to)395-401
Number of pages7
JournalActa Oto-Laryngologica
Issue number5
Early online date12 May 2022
Publication statusPublished - 2022


  • biofilm
  • Cochlear implant infection
  • fluorescence in situ hybridization
  • microbial analysis
  • microbial community profiling

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