Abstract
Subclinical bacterial infections (biofilms) are strongly implicated in breast augmentation failure due to capsular contracture, and while these infections are generally ascribed to common skin commensals, this remains largely unsubstantiated through robust cultivation independent analyses. To determine capsule biofilm microbial community compositions, we employed amplicon sequencing of the 16S rRNA gene using DNA extracted from breast implant capsule samples. These cultivation independent analyses revealed that capsule associated biofilms are more diverse than canonical single-species infections, but have relatively low diversity (~ <100 species) compared to many host-associated microbial communities. In addition to taxa commonly associated with capsular contracture, the biofilms analyzed comprised a number of taxa that escaped detection in cultivation-dependent work. We have also isolated several key taxa identified through the culture-independent analyses. Together our analyses reveal that capsule biofilms are more diverse than cultivation studies suggest and can be heterogeneous within an individual capsule, between breasts of the same patient, across similar implant types, and over a range in severity of contracture. The complex nature of these communities requires further study across a broader suite of patients in addition to higher resolution analyses including metagenomics to better assess the fundamental role of microorganisms in capsular contracture.
Highlights
The human body is comprised of more than one microbial cell for every human cell [1] and these microbial cells, the human microbiome, are both taxonomically and physiologically diverse
High quality DNA was recovered from all samples, but some samples (Table 1) did not yield amplicons of either bacterial or archaeal 16S rRNA genes, even through nested PCR amplification
Microbial DNA was successfully detected, defined as a positive amplification of the 16S rRNA gene, in capsules from 14 of 17 patients, or in more than 80% of cases
Summary
The human body is comprised of more than one microbial cell for every human cell [1] and these microbial cells, the human microbiome, are both taxonomically and physiologically diverse. The metabolic blueprint that codes for healthy human physiology is distributed across more than 2000 Mb (assuming more than 1000 species with mean genome sizes of 2 Mb) of non-redundant microbial genomic information in addition to the 3200 Mb of the human genome [2]. This hidden majority of microbial cells and genomic information often plays an outsized role in human health impacting inflammation, immunity, and a vast array of acute. They had roles in data interpretation, manuscript preparation and decision to publish
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