1887

Abstract

Purpose. Biofilms comprise bacterial populations enclosed in a matrix that attaches to surfaces such as medical stents. We characterized the biofilm components in occluding pancreatic stents and investigated potential factors for the formation of the biofilms.

Methodology. The clinical details of 24 patients (M : F, 15 : 9) undergoing pancreatic stent retrieval were noted and the retrieved stents were processed for the quantification of biofilm proteins and polysaccharides and the molecular identification of bacteria.

Results. The patients’ ages ranged from 16 to 62 years. The underlying indications for stent insertion were bile duct stone prophylaxis against post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (n=7; 29.1 %) and pancreatic ductal leaks (n=17; 70.9 %). The retrieved stent sizes were 5 Fr (n=5; 20.8 %) and 7 Fr (n=19; 79.2 %), with a mean insertion duration of 103 days. The polybacteria detected by PCR in 95.8 % of the stents were Pseudomonas (n=8), Staphylococcus (n=8), Serratia (n=5), Aeromonas (n=4), Proteus (n=4), Klebsiella (n=4), Escherichia coli (n=4), Enterococcus (n=4), Streptococcus (n=4), Citrobacter (n=3), Bacillus (n=2), Enterobacter (n=1), Vibrio (n=1) and Clostridium (n=1). Several other organisms were identified by sequencing. The mean protein concentration was 0.585±0.29 mg ml and the mean polysaccharide concentration was 0.054±0.03 mg ml. No significant differences were observed in the quantity of proteins and polysaccharides (P=0.933) for various factors, namely gender, presence of cholangitis, indications for stenting, stent sizes and duration of indwelling stents. Age was found to be a significant (P=0.013) factor for protein deposition for those aged >50 years.

Conclusion. The majority of the pancreatic stents grew polymicro-organisms, and those from patients aged >50 years showed significant deposition of protein, which is a key element in biofilm formation. Understanding the constituents of the biofilms in pancreatic stents could be very useful in developing future strategies for the prevention of biofilm formation.

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2018-07-27
2024-03-29
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References

  1. Hill SK, Bhalla C, Thomson A. Risk of bacterial colonization of pancreatic stents used in endoscopic retrograde cholangiopancreatography. J Clin Gastroenterol 2012; 46:324–327 [View Article][PubMed]
    [Google Scholar]
  2. Testoni PA. Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases. World J Gastroenterol 2007; 13:5971–5978 [View Article][PubMed]
    [Google Scholar]
  3. Yeoh KG, Zimmerman MJ, Cunningham JT, Cotton PB. Comparative costs of metal versus plastic biliary stent strategies for malignant obstructive jaundice by decision analysis. Gastrointest Endosc 1999; 49:466–471 [View Article][PubMed]
    [Google Scholar]
  4. Sung JY, Leung JW, Shaffer EA, Lam K, Olson ME et al. Ascending infection of the biliary tract after surgical sphincterotomy and biliary stenting. J Gastroenterol Hepatol 1992; 7:240–245 [View Article][PubMed]
    [Google Scholar]
  5. Ahimou F, Semmens MJ, Haugstad G, Novak PJ. Effect of protein, polysaccharide, and oxygen concentration profiles on biofilm cohesiveness. Appl Environ Microbiol 2007; 73:2905–2910 [View Article][PubMed]
    [Google Scholar]
  6. Wilkins M, Hall-Stoodley L, Allan RN, Faust SN. New approaches to the treatment of biofilm-related infections. J Infect 2014; 69:S47–S52 [View Article][PubMed]
    [Google Scholar]
  7. Vaishnavi C, Samanta J, Kochhar R. Characterization of biofilms in biliary stents and potential factors involved in occlusion. World J Gastroenterol 2018; 24:112–123 [View Article][PubMed]
    [Google Scholar]
  8. Raunkjær K, Hvitved-Jacobsen T, Nielsen PH. Measurement of pools of protein, carbohydrate and lipid in domestic wastewater. Water Res 1994; 28:251–262 [View Article]
    [Google Scholar]
  9. Muyzer G, Brinkhoff T, NuÈ bel U, Santegoeds C, SchaÈfer H et al. Denaturing gradient gel electrophoresis (DGGE) in microbial ecology. In Molecular Microbial Ecology Manual the Netherlands: Kluwer Academic Publishers; 1997 pp. 1–27
    [Google Scholar]
  10. Sánchez O, Gasol JM, Massana R, Mas J, Pedrós-Alió C. Comparison of different denaturing gradient gel electrophoresis primer sets for the study of marine bacterioplankton communities. Appl Environ Microbiol 2007; 73:5962–5967 [View Article][PubMed]
    [Google Scholar]
  11. Weitz G, Woitalla J, Wellhöner P, Schmidt K, Büning J et al. Does etiology of acute pancreatitis matter? A review of 391 consecutive episodes. JOP 2015; 16:171–175[PubMed]
    [Google Scholar]
  12. Spanier BW, Dijkgraaf MG, Bruno MJ. Epidemiology, aetiology and outcome of acute and chronic pancreatitis: an update. Best Pract Res Clin Gastroenterol 2008; 22:45–63 [View Article][PubMed]
    [Google Scholar]
  13. Donelli G, Guaglianone E, di Rosa R, Fiocca F, Basoli A. Plastic biliary stent occlusion: factors involved and possible preventive approaches. Clin Med Res 2007; 5:53–60 [View Article][PubMed]
    [Google Scholar]
  14. Costerton JW, Lewandowski Z, Caldwell DE, Korber DR, Lappin-Scott HM. Microbial biofilms. Annu Rev Microbiol 1995; 49:711–745 [View Article][PubMed]
    [Google Scholar]
  15. O'Toole G, Kaplan HB, Kolter R. Biofilm formation as microbial development. Annu Rev Microbiol 2000; 54:49–79 [View Article][PubMed]
    [Google Scholar]
  16. Cucarella C, Solano C, Valle J, Amorena B, Lasa I et al. Bap, a Staphylococcus aureus surface protein involved in biofilm formation. J Bacteriol 2001; 183:2888–2896 [View Article][PubMed]
    [Google Scholar]
  17. Kwon CI, Lehman GA. Mechanisms of biliary plastic stent occlusion and efforts at prevention. Clin Endosc 2016; 49:139–146 [View Article][PubMed]
    [Google Scholar]
  18. Kozarek R, Hovde O, Attia F, France R. Do pancreatic duct stents cause or prevent pancreatic sepsis?. Gastrointest Endosc 2003; 58:505–509 [View Article][PubMed]
    [Google Scholar]
  19. Noor MT, Radhakrishna Y, Kochhar R, Ray P, Wig JD et al. Bacteriology of infection in severe acute pancreatitis. JOP 2011; 12:19–25[PubMed]
    [Google Scholar]
  20. Runkel NS, Moody FG, Smith GS, Rodriguez LF, Larocco MT et al. The role of the gut in the development of sepsis in acute pancreatitis. J Surg Res 1991; 51:18–23 [View Article][PubMed]
    [Google Scholar]
  21. Vaishnavi C. Translocation of gut flora and its role in sepsis. Indian J Med Microbiol 2013; 31:334–342 [View Article][PubMed]
    [Google Scholar]
  22. Schneider J, Schenk P, Obermeier A, Fremd J, Feihl S et al. Microbial colonization of pancreatic duct stents: a prospective analysis. Pancreas 2015; 44:786–790 [View Article][PubMed]
    [Google Scholar]
  23. Schneider J, Hapfelmeier A, Fremd J, Schenk P, Obermeier A et al. Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation. PLoS One 2014; 9:e110112 [View Article][PubMed]
    [Google Scholar]
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