MP35-10 NEXT-GENERATION SEQUENCING APPEARS TO RECHARACTERIZE BIOFILM FROM INFECTED PENILE IMPLANTS: HAVE WE BEEN WRONG?

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-10 NEXT-GENERATION SEQUENCING APPEARS TO RECHARACTERIZE BIOFILM FROM INFECTED PENILE IMPLANTS: HAVE WE BEEN WRONG? Paul H. Chung, Erica Mann, Joon Yau Leong, and Gerald Henry Paul H. ChungPaul H. Chung More articles by this author , Erica MannErica Mann More articles by this author , Joon Yau LeongJoon Yau Leong More articles by this author , and Gerald HenryGerald Henry More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Next-generation sequencing (NGS) may provide deeper insight into the biofilm of infected penile implants. Historically, gram-positive skin organisms were most commonly thought to contribute to implant infection. We hypothesize that biofilm detected on penile implants removed due to infection constitute different organisms than those on devices removed for mechanical failure. METHODS: An IRB-approved retrospective review was performed of patients who underwent penile implant removal at two institutions. At time of explant, devices were swabbed with sterile gauze which was sent for NGS testing. Molecular testing of 16s ribosomal RNA was performed by NGS using an Illumina MiSeq sequencing platform (San Diego, CA). Variable regions 1-2 of 16S rDNA gene were amplified and prepared into libraries for sequencing using primers 28F and 388R. Organisms present at <2.0% abundance were considered rare and not included in summary analyses. RESULTS: 95 total implants were evaluated and 52 met study criteria (14 for infection, 38 for mechanical failure). The most prevalent five organisms from each device were assessed. Escherichia coli was one of the top five most abundant organisms of infected and non-infected devices. The other most prevalent organisms on infected devices were Pseudomonas aeruginosa, Enterococcus faecalis, Aerococcus urinae, and Corynebacterium jeikeium. On devices removed for mechanical failure, they were Cutibacterium acnes, Finegoldia magna, Staphylococcus epidermidis, and Burkholderia cepacia. Of the top seven most prevalent genus on implants removed for infection, the ratio of gram positive:gram negative was 5:2 and for devices removed for mechanical indications was 4:3. Common implant antibiotic coatings and dip combinations were broadly reviewed and had similar challenges covering bacteria identified with gentamycin and vancomycin providing the best coverage. CONCLUSIONS: Penile implants removed for infection versus mechanical failure were more pathogenic with organisms different than historically understood. Additional studies will help to further characterize differences and establish whether common antibiotic combinations for prophylaxis, irrigation, and implant coatings should be altered. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e630-e631 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul H. Chung More articles by this author Erica Mann More articles by this author Joon Yau Leong More articles by this author Gerald Henry More articles by this author Expand All Advertisement Loading ...