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Objective: To determine whether bacterial biofilms are present on pediatric tracheotomy tubes. Design: Prospective observational series. Interventions: Eleven tracheotomy tubes removed during routine tracheotomy tube changes were analyzed for biofilm and live bacteria presence using confocal microscopy and vital stains. The external and internal surfaces of the tracheotomy tubes were studied in 3 locations: distal tip, midtracheotomy tube, and proximal opening. These data were correlated withdoi:10.1001/archotol.130.3.339 pmid:15023844 fatcat:ysimrmqvgfevpo5vx7q736buxa