Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 51 1 2022 01 03 151 159 Hasti Kamali sarvestani Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Roshanak Daie Ghazvini Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Syed Jamal Hashemi 1. Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran Mohsen Geramishoar Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Saham Ansari Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Zahra Rafat Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Aslan Ahmadi Head and Neck Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Pedram Borghei Department of Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Miad Elahi Department of Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Abas Rahmi foroushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Muhammad Ibrahim Getso 1. Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University Kano, PMB 3011, Kano, Nigeria Shima Aboutalebian Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Fatemeh Safari Department of Microbiology, Islamic Azad University, Falavarjan Branch, Isfahan, Iran Pegah Ardi Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2020 08 24 2021 02 06 Background: Tracheoesophageal voice prostheses (TVPs) have been the gold standard in rehabilitation, after laryngectomy, producing faster and premier voicing towards esophageal speech. Fungal colonization shortens the device’s lifetime and leads to prosthesis dysfunction, leakage, and subsequent respiratory infection. Therefore, in the current study, we aimed to investigate the fungal colonization patterns and to propose prophylactic measures that shall increase the longevity of voice prosthesis. Methods: Failed TVPs were removed - due to leakage and/or aspiration - from 66 post laryngectomy patients and examined. They were referred to Amiralam and Rasoul Hospital, the main centers of Ear, Nose, and Throat in Tehran, Iran from April 2018 to January 2020. Fungal colonization patterns were assessed using DNA sequencing techniques. Furthermore, the susceptibility to fluconazole, amphotericin B, nystatin, and white vinegar was evaluated according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Resident fungal species from the upper airways colonized all the 66 TVPs (100%). Diabetes (31%) and smoking (98%) were the predominant underlying disease and predisposing factors, respectively. Among the 79 fungal agents isolated from the 66 TVPs, Candida glabrata (n=25, 31.7%) was the most common. A significant reduction in minimum inhibitory concentration (MIC) values were observed for white vinegar when used alone (P<0.05). Conclusion: White vinegar at a very low concentration could decrease the amount of fungal colonization on TVPs without any adverse effects; its wide accessibility and affordability ensure a decrease in the overall health cost. https://ijph.tums.ac.ir/index.php/ijph/article/view/21787 https://ijph.tums.ac.ir/index.php/ijph/article/download/21787/7476