Abstract
Despite routine implementation in urology, indwelling ureteral stents pose as a nidus for infection. Conditioning film accumulates on stents, which prime pathogen adhesion, promoting infectious biofilm formation. However, the extent to which conditioning film components play a role in facilitating bacterial adhesion and biofilm formation remains largely unknown. Here, we examined the interaction of previously identified stent-bound conditioning film components (fibrinogen, uromodulin, and albumin) with bacterial uropathogens. Cytoscopically removed stents were incubated with common uropathogens (Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus). Immunofluorescent double staining was performed to study the localization of uropathogens relative to stent-bound conditioning film proteins. Conditioning film components were identified on the external stent surface with some deposition in the inner lumen. Bacteria co-localized with fibrinogen, uromodulin, and albumin, suggesting a potential mechanism for stent-associated infections. Here, we determine strong co-localization between common uropathogenic bacterial species with prominent conditioning film components on ureteral stents. Further functional validation of interactions amongst these uropathogens and conditioning film proteins may enhance clinical management for stent-associated infections and development of improved stent technologies.
Highlights
Bacterial biofilms pose a significant problem throughout medicine, as their formation on indwelling devices is significantly associated with infectious sequelae
The common uropathogens Enterococcus faecalis, Escherichia coli, and Staphylococcus aureus were incubated with explanted ureteral stent pieces
A nonuniform and scattered distribution of bacterial colonization across the surface of the stents was observed for all uropathogenic species tested (Figure 3)
Summary
Bacterial biofilms pose a significant problem throughout medicine, as their formation on indwelling devices is significantly associated with infectious sequelae. Biofilm is a structured community of microorganisms and their extracellular products that aggregates on host tissue or implanted medical devices [1,2]. The basic unit of biofilm is called a microcolony, comprising cells in addition to an exopolysaccharide matrix. This matrix is a microenvironment rich in proteins, DNA, and polysaccharides that sustain colony survival and proliferation [3]. While often existing in a free-floating, planktonic state, many pathogens have the ability to adhere to structures and to persist in this arrangement by forming matrices that incorporate other molecular structures (Figure 1).
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