Transvaginal Mesh-related Complications and the Potential Role of Bacterial Colonization: An Exploratory Observational Study

被引:1
|
作者
Diedrich, Chantal M. [1 ,2 ,8 ]
Verhorstert, Kim W. J. [1 ,2 ]
Riool, Martijn [2 ]
Schuster, Heleen [1 ,2 ]
de Boer, Leonie [2 ]
Kikhney, Judith [3 ,4 ,5 ,6 ]
Moter, Annette [3 ,4 ,5 ,6 ,7 ]
Zaat, Sebastian A. J. [2 ]
Roovers, Jan-Paul W. R. [1 ]
机构
[1] Univ Amsterdam, Dept Obstet & Gynecol Amsterdam Reprod & Dev, Amsterdam UMC, Meibergdreef 9, Amsterdam, Netherlands
[2] Univ Amsterdam, Amsterdam Inst Infect & Immun, Dept Med Microbiol & Infect Prevent, Amsterdam UMC, Meibergdreef 9, Amsterdam, Netherlands
[3] Charite Univ Med Berlin, Hindenburgdamm 30, D-12203 Berlin, Germany
[4] Free Univ Berlin, Hindenburgdamm 30, D-12203 Berlin, Germany
[5] Humboldt Univ, Inst Microbiol Infect Dis & Immunol, Biofilmctr, Hindenburgdamm 30, D-12203 Berlin, Germany
[6] MoKi Analyt GmbH, Hindenburgdamm 30, D-12203 Berlin, Germany
[7] Practice Moter Diagnost Practice, Marienpl 9, D-12207 Berlin, Germany
[8] Univ Amsterdam, Dept Obstet & Gynecol, Amsterdam Reprod & Dev, Amsterdam UMC Locat AMC, Meibergdreef 9, Amsterdam, Netherlands
关键词
Bacterial biofilm; Mesh-related complication; Pelvic organ prolapse; PELVIC ORGAN PROLAPSE; IN-SITU HYBRIDIZATION; TARGETED OLIGONUCLEOTIDE PROBES; URINARY-INCONTINENCE; INFECTIONS; IDENTIFICATION; MANAGEMENT;
D O I
10.1016/j.jmig.2022.11.011
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective: This study aimed to investigate the potential role of transvaginal mesh bacterial colonization in the devel-opment of mesh-related complications (MRCs).Design: An observational and exploratory study.Setting: Tertiary referral center (Amsterdam UMC, location AMC, Amsterdam, The Netherlands).Patieeuronts: 49 patients indicated for mesh removal and 20 women of whom vaginal tissue was retrieved during prolapse sur-gery as a reference cohort. Interventions: collection of mesh-tissue complex (patient cohort) or vaginal tissue (reference cohort)Measurements and Main results: Homogenized samples were used for quantitative microbiological culture. Inflammation and fibrosis were semiquantitatively histologically scored; Gram staining and fluorescence in situ hybridization were used to detect bacteria and bacterial biofilms. Of the 49 patients, 44 samples (90%) were culture positive, with a higher diversity of species and more Gram-negative bacteria and polymicrobial cultures in the MRC cohort than the reference cohort, with mostly staphylococci, streptococci, Actinomyces spp., Cutibacterium acnes, and Escherichia coli. Patients with clinical signs of infection or exposure had the highest bacterial counts. Histology demonstrated moderate to severe inflammation in most samples. Gram staining showed bacteria in 57% of cul-ture-positive samples, and in selected samples, fluorescence in situ hybridization illustrated a polymicrobial biofilm. Conclusion: In this study, we observed distinct differences in bacterial numbers and species between patients with MRCs and a reference cohort. Bacteria were observed at the mesh-tissue interface in a biofilm. These results strongly support the potential role of bacterial mesh colonization in the development of MRCs. Journal of Minimally Invasive Gynecology (2023) 30, 205-215. (c) 2022 AAGL. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
引用
收藏
页码:205 / 215
页数:11
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