Werneburg Glenn T, Hettel Daniel, Goldman Howard B, Vasavada Sandip P, Miller Aaron W
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
Urology. 2025 Feb;196:82-89. doi: 10.1016/j.urology.2024.10.021. Epub 2024 Oct 10.
To characterize microbial biofilms associated with different device types used in the urological field including ureteral stents, sacral neuromodulation (SNM) devices, penile prostheses, and artificial urinary sphincters (AUS).
Data from 4 studies, each reporting biofilm composition of a particular device type, were pooled and included for inter-device analysis. Studies recruited adults scheduled for ureteral stent, SNM, IPP, or AUS removal/revision. Device (n = 115) biofilms and controls were analyzed with multi-omics approaches, and compositions were compared across device types and clinical factors.
Microbiota present on each device type was distinct from that of perineal, rectal, or urine flora (P <.01). Biofilm microbial counts (P <.001) and diversity (P = .024) differed by device type. Ureteral stents had greater microbial counts than other device types (P <.001). Staphylococcus, Pseudomonas, Lactobacillus, Ureaplasma were commonly detected across devices. Device biofilms harbored a greater proportion of Proteobacteria phylum, and the rectal, perineal, and urine flora harbored a greater proportion of Firmicutes. Unique microbe-metabolite interaction networks were identified in presence and absence of infection. Antibiotic-resistance genes including sul2 (sulfonamide resistance) and rpoB (rifampin resistance) were detected in biofilms across device types. Biofilm reconstitution in vitro differed by device type from which strains were isolated.
Ureteral stents, sacral neuromodulation devices, penile prostheses, and artificial urinary sphincters harbored unique microbial and metabolite profiles that differed from those of skin, urine, and rectal flora. The findings of this study set the groundwork for investigation of novel strategies to reduce device-associated infection risk within and outside urology.
描述与泌尿外科领域使用的不同类型器械相关的微生物生物膜，这些器械包括输尿管支架、骶神经调节（SNM）装置、阴茎假体和人工尿道括约肌（AUS）。
汇总4项研究的数据，每项研究报告一种特定器械类型的生物膜组成，并纳入进行器械间分析。研究招募了计划进行输尿管支架、SNM、阴茎假体植入（IPP）或AUS取出/翻修的成年人。使用多组学方法分析器械（n = 115）生物膜和对照，并比较不同器械类型和临床因素的组成。
每种器械类型上存在的微生物群与会阴、直肠或尿液菌群不同（P <.01）。生物膜微生物计数（P <.001）和多样性（P = 0.024）因器械类型而异。输尿管支架的微生物计数高于其他器械类型（P <.001）。葡萄球菌、假单胞菌、乳杆菌、脲原体在各种器械中均普遍检测到。器械生物膜中变形菌门的比例更高，而直肠、会阴和尿液菌群中厚壁菌门的比例更高。在有无感染的情况下均鉴定出独特的微生物-代谢物相互作用网络。在各种器械类型的生物膜中均检测到包括sul2（磺胺耐药）和rpoB（利福平耐药）在内的抗生素抗性基因。体外生物膜重建因分离菌株的器械类型而异。
输尿管支架、骶神经调节装置、阴茎假体和人工尿道括约肌具有独特的微生物和代谢物谱，与皮肤、尿液和直肠菌群不同。本研究结果为研究降低泌尿外科内外器械相关感染风险的新策略奠定了基础。
