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Direct demonstration of bacterial biofilms on prosthetic mesh after ventral herniorrhaphy

Direct demonstration of bacterial biofilms on prosthetic mesh after ventral herniorrhaphy
Direct demonstration of bacterial biofilms on prosthetic mesh after ventral herniorrhaphy
Background: Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biofilms on mesh surfaces in vitro, they have never been visualized directly in biofilms on mesh recovered from patients experiencing infectious complications.

Methods: Five patients who developed complications after ventral hernia repair with prosthetic mesh were operated on again. Explanted mesh was examined for biofilm with confocal laser scanning microscopy (CLSM) and fluorescence in situ hybridization (FISH). In two cases, a novel molecular assay (the Ibis T5000) was used to characterize the biofilm-forming bacteria.

Results: The CLSM examination demonstrated adherent biofilms on mesh surfaces in all five patients. Biofilms also were noted on investing fibrous tissue. The FISH study was able to discriminate between bacterial species in polymicrobial biofilms. In two patients the Ibis T5000 detected more species of constituent biofilm bacteria than did standard culture. Removal of the mesh and reconstruction with autologous tissues or biologic materials resolved the presenting complaints in all cases.

Conclusion: Bacterial biofilms should be considered an important contributor to the pathology and complications associated with prosthetic mesh implanted in the abdominal wall. If biofilms are present, complete removal of the mesh and repair of the resulting defect without alloplastic materials is an effective intervention
Direct demonstration of bacterial biofilms on prosthetic mesh after ventral herniorrhaphy
1096-2964
45-53
Kathju, Sandeep
80cdb7ee-2e0d-4e70-98c9-93682ce05a09
Nistico, Laura
7a83886a-6bf1-46a1-87dd-75a120d41603
Melton-Kreft, Rachael
3a19cfa1-d348-4147-a252-5c54196421d4
Lasko, Leslie-Ann
ebb30e0c-c716-448e-8ff8-dba4a119f9cc
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
Kathju, Sandeep
80cdb7ee-2e0d-4e70-98c9-93682ce05a09
Nistico, Laura
7a83886a-6bf1-46a1-87dd-75a120d41603
Melton-Kreft, Rachael
3a19cfa1-d348-4147-a252-5c54196421d4
Lasko, Leslie-Ann
ebb30e0c-c716-448e-8ff8-dba4a119f9cc
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f

Kathju, Sandeep, Nistico, Laura, Melton-Kreft, Rachael, Lasko, Leslie-Ann and Stoodley, Paul (2015) Direct demonstration of bacterial biofilms on prosthetic mesh after ventral herniorrhaphy. Surgical Infections, 16 (1), 45-53. (doi:10.1089/sur.2014.026). (PMID:25761080)

Record type: Article

Abstract

Background: Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biofilms on mesh surfaces in vitro, they have never been visualized directly in biofilms on mesh recovered from patients experiencing infectious complications.

Methods: Five patients who developed complications after ventral hernia repair with prosthetic mesh were operated on again. Explanted mesh was examined for biofilm with confocal laser scanning microscopy (CLSM) and fluorescence in situ hybridization (FISH). In two cases, a novel molecular assay (the Ibis T5000) was used to characterize the biofilm-forming bacteria.

Results: The CLSM examination demonstrated adherent biofilms on mesh surfaces in all five patients. Biofilms also were noted on investing fibrous tissue. The FISH study was able to discriminate between bacterial species in polymicrobial biofilms. In two patients the Ibis T5000 detected more species of constituent biofilm bacteria than did standard culture. Removal of the mesh and reconstruction with autologous tissues or biologic materials resolved the presenting complaints in all cases.

Conclusion: Bacterial biofilms should be considered an important contributor to the pathology and complications associated with prosthetic mesh implanted in the abdominal wall. If biofilms are present, complete removal of the mesh and repair of the resulting defect without alloplastic materials is an effective intervention

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More information

Published date: February 2015
Keywords: Direct demonstration of bacterial biofilms on prosthetic mesh after ventral herniorrhaphy
Organisations: nCATS Group

Identifiers

Local EPrints ID: 375236
URI: http://eprints.soton.ac.uk/id/eprint/375236
ISSN: 1096-2964
PURE UUID: 8ccc79e9-208e-4df0-99b1-8613127ea40a
ORCID for Paul Stoodley: ORCID iD orcid.org/0000-0001-6069-273X

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Date deposited: 17 Mar 2015 13:14
Last modified: 15 Mar 2024 03:34

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Contributors

Author: Sandeep Kathju
Author: Laura Nistico
Author: Rachael Melton-Kreft
Author: Leslie-Ann Lasko
Author: Paul Stoodley ORCID iD

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