Frost Fabian, Khaimov Valeria, Senz Volkmar, Weiss Stefan, Klußmann-Fricke Bastian, Rühlemann Malte, Bang Corinna, Franke Andre, Pickartz Tilman, Budde Christoph, Aghdassi Ali A, Siewert Stefan, Weiss Frank U, Grabow Niels, Lerch Markus M, Sendler Matthias
Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
Institute for Implant Technology and Biomaterials E. V., Rostock, Germany.
Front Med (Lausanne). 2024 Sep 16;11:1462122. doi: 10.3389/fmed.2024.1462122. eCollection 2024.
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.
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.
The stent microbiome comprises a large proportion of opportunistic enteric pathogens such as (14.4%) or (6.1%) as well as oral bacteria like (13.1%). Increased levels of opportunistic enteric pathogens were associated with a prolonged hospital stay ( = 0.77, = 3e-06) and the occurrence of adverse events during drainage therapy ( = 0.011). Higher levels of oral bacteria were associated ( = -0.62, = 8e-04) with shorter durations of inpatient treatment. SEM and μCT investigations revealed complex biofilm networks on the stent surface.
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.
胰腺坏死或假性囊肿的形成是胰腺炎的典型并发症，可能需要使用金属或塑料支架进行内镜引流治疗。这些病变的微生物感染构成了重大挑战。尽管内镜引流治疗期间微生物定植在引流支架上的组成和意义可能会影响治疗结果，但到目前为止，其在很大程度上尚不清楚。
共取回26个用于胰腺病变引流的支架，通过16S rRNA基因测序确定支架微生物群。额外的分析包括将支架微生物群与腔内坏死微生物群进行比较，以及对选定的金属或塑料支架进行扫描电子显微镜（SEM）和微计算机断层扫描（μCT）成像。
支架微生物群包含很大比例的机会性肠道病原体，如（14.4%）或（6.1%），以及口腔细菌，如（13.1%）。机会性肠道病原体水平升高与住院时间延长（=0.77，=3e-06）和引流治疗期间不良事件的发生（=0.011）相关。口腔细菌水平较高与住院治疗时间较短相关（= -0.62，=8e-04）。SEM和μCT研究揭示了支架表面复杂的生物膜网络。
支架微生物群的组成与内镜引流治疗期间住院时间延长和不良事件相关，突出了有效感染控制以改善患者预后的必要性。除了全身抗生素治疗外，抗菌支架涂层可能是一种可行的选择，以影响支架微生物群，并可能加强对坏死微生物群的控制。
