Chung Paul H, Leong Joon Yau, Phillips Caleb D, Henry Gerard D
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: https://twitter.com/@jyleong_md.
J Sex Med. 2022 Feb;19(2):356-363. doi: 10.1016/j.jsxm.2021.11.014. Epub 2021 Dec 26.
Next-generation sequencing (NGS) is an emerging technology that may allow for more sensitive and sophisticated microbial testing of the microbiota of penile prostheses (PP).
To describe the microorganism profiles of PP explanted for infection, erosion, and mechanical malfunction using NGS.
All patients who underwent PP removal by two physicians at two institutions were identified. Differences in alpha diversity (ie, number of species detected, species diversity across samples) and microbiome compositional profiles (Bray-Curtis community dissimilarities) across samples were assessed using ANOVA and PERMANOVA, respectively.
Number of species detected, species diversity across samples, and microbiome compositional profiles.
A total of 83 patients who underwent device removal for infection (n = 8, 10%), erosion (n = 5, 6%), and mechanical malfunction (n = 70, 84%) were included. When considering all devices, 56% (n = 48) of NGS and 29% (n = 24) of standard cultures resulted positive for presence of microorganisms. Culture only detected the most abundant NGS species in 62.5% (n = 5) of infected devices. Species richness and microbiome compositional profiles varied by surgical indication, but not by age, race, diabetes status, or implant duration. Most frequent organisms by surgical indication were Pseudomonas aeruginosa (infection), Staphylococcus epidermidis (erosion), and Escherichia coli (mechanical malfunction). The highest relative abundance organisms were P aeruginosa (infection), Corynebacterium jeikeium (erosion), and E coli (mechanical malfunction).
Identifying microbiome profiles of PP removed for infection, erosion, and mechanical malfunction may guide the selection of peri-operative antibiotics and PP antibiotic coatings or hydrophilic dip solutions for each individual scenario.
While this is the first study to utilize next-generation sequencing to evaluate penile prosthesis biofilm, the clinical significance of these findings has yet to be determined. A prospective, randomized trial aimed at evaluating the clinical significance of NGS in patients with PP infection is currently underway.
NGS testing identified distinct microbiome profiles of PP removed for infection, erosion, and mechanical malfunction. Chung PH, Leong JY, Phillips CD, Henry GD. Microorganism Profiles of Penile Prosthesis Removed for Infection, Erosion, and Mechanical Malfunction Based on Next-Generation Sequencing. J Sex Med 2022;19:356-363.
下一代测序（NGS）是一项新兴技术，可能使阴茎假体（PP）微生物群的检测更加灵敏和精细。
使用NGS描述因感染、侵蚀和机械故障而取出的PP的微生物谱。
确定在两家机构由两名医生进行PP取出术的所有患者。分别使用方差分析（ANOVA）和多变量方差分析（PERMANOVA）评估样本间的α多样性（即检测到的物种数量、样本间的物种多样性）和微生物组成谱（Bray-Curtis群落差异）。
检测到的物种数量、样本间的物种多样性和微生物组成谱。
共有83例患者因感染（n = 8，10%）、侵蚀（n = 5，6%）和机械故障（n = 70，84%）而取出装置。考虑所有装置时，56%（n = 48）的NGS检测和29%（n = 24）的标准培养物微生物检测呈阳性。培养仅在62.5%（n = 5）的感染装置中检测到最丰富的NGS物种。物种丰富度和微生物组成谱因手术指征而异，但不因年龄、种族、糖尿病状态或植入时间而异。按手术指征最常见的微生物是铜绿假单胞菌（感染）、表皮葡萄球菌（侵蚀）和大肠杆菌（机械故障）。相对丰度最高的微生物是铜绿假单胞菌（感染）、杰氏棒状杆菌（侵蚀）和大肠杆菌（机械故障）。
确定因感染、侵蚀和机械故障而取出的PP的微生物谱可能指导针对每种具体情况选择围手术期抗生素以及PP抗生素涂层或亲水性浸液。
虽然这是第一项利用下一代测序评估阴茎假体生物膜的研究，但这些发现的临床意义尚未确定。一项旨在评估NGS在PP感染患者中临床意义的前瞻性随机试验正在进行中。
NGS检测确定了因感染、侵蚀和机械故障而取出的PP的不同微生物谱。钟PH，梁JY，菲利普斯CD，亨利GD。基于下一代测序的因感染、侵蚀和机械故障而取出的阴茎假体的微生物谱。《性医学杂志》2022；19：356 - 363。
