The composition of the stent microbiome is associated with morbidity and adverse events during endoscopic drainage therapy of pancreatic necroses and pseudocysts.
| Autor: | Frost F; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany., Khaimov V; Institute for Implant Technology and Biomaterials E. V., Rostock, Germany., Senz V; Institute for Biomedical Engineering, Rostock University Medical Center, Rostock, Germany., Weiss S; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.; Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany., Klußmann-Fricke B; Institute for Implant Technology and Biomaterials E. V., Rostock, Germany., Rühlemann M; Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany., Bang C; Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany., Franke A; Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany., Pickartz T; Department of Internal Medicine IV, Klinikum Südstadt Rostock, Rostock, Germany., Budde C; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany., Aghdassi AA; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany., Siewert S; Institute for Implant Technology and Biomaterials E. V., Rostock, Germany., Weiss FU; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany., Grabow N; Institute for Biomedical Engineering, Rostock University Medical Center, Rostock, Germany., Lerch MM; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.; Ludwig Maximilian University Hospital, Ludwig Maximilian University of Munich, Munich, Germany., Sendler M; Department of Medicine A, University Medicine Greifswald, Greifswald, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in medicine [Front Med (Lausanne)] 2024 Sep 16; Vol. 11, pp. 1462122. Date of Electronic Publication: 2024 Sep 16 (Print Publication: 2024). |
| DOI: | 10.3389/fmed.2024.1462122 |
| Abstrakt: | Background: Development of pancreatic necroses or pseudocysts are typical complications of pancreatitis and may require endoscopic drainage therapy using metal or plastic stents. Microbial infection of these lesions poses a major challenge. So far, the composition and significance of the microbial colonization on drainage stents are largely unknown although it may impact outcomes during endoscopic drainage therapy. Methods: A total of 26 stents used for drainage of pancreatic lesions were retrieved and the stent microbiome was determined by 16S rRNA gene sequencing. Additional analysis included comparison of the stent microbiome to the intracavitary necrosis microbiome as well as scanning electron microscopy (SEM) and micro-computed tomography (μCT) imaging of selected metal or plastic stents. Results: The stent microbiome comprises a large proportion of opportunistic enteric pathogens such as Enterococcus (14.4%) or Escherichia (6.1%) as well as oral bacteria like Streptococcus (13.1%). Increased levels of opportunistic enteric pathogens were associated with a prolonged hospital stay ( r = 0.77, p = 3e-06) and the occurrence of adverse events during drainage therapy ( p = 0.011). Higher levels of oral bacteria were associated ( r = -0.62, p = 8e-04) with shorter durations of inpatient treatment. SEM and μCT investigations revealed complex biofilm networks on the stent surface. Conclusion: The composition of the stent microbiome is associated with prolonged hospital stays and adverse events during endoscopic drainage therapy, highlighting the need for effective infection control to improve patient outcomes. In addition to systemic antibiotic therapy, antimicrobial stent coatings could be a conceivable option to influence the stent microbiome and possibly enhance control of the necrotic microflora. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Frost, Khaimov, Senz, Weiss, Klußmann-Fricke, Rühlemann, Bang, Franke, Pickartz, Budde, Aghdassi, Siewert, Weiss, Grabow, Lerch and Sendler.) |
| Databáze: | MEDLINE |
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