You have accessJournal of UrologyCME1 May 2022PD34-01 SACRAL NEUROMODULATION DEVICES CONSISTENTLY HARBOR BACTERIA AND POSSESS A UNIQUE MICROBE AND METABOLITE PROFILE Glenn T. Werneburg, Ava Adler, Daniel Hettel, Sandip Vasavada, Raymond Rackley, Howard Goldman, Jacqueline Zillioux, Bradley Gill, Daniel Shoskes, and Aaron Miller Glenn T. WerneburgGlenn T. Werneburg More articles by this author , Ava AdlerAva Adler More articles by this author , Daniel HettelDaniel Hettel More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , Raymond RackleyRaymond Rackley More articles by this author , Howard GoldmanHoward Goldman More articles by this author , Jacqueline ZilliouxJacqueline Zillioux More articles by this author , Bradley GillBradley Gill More articles by this author , Daniel ShoskesDaniel Shoskes More articles by this author , and Aaron MillerAaron Miller More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002585.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sacral neuromodulation (SNM) is an effective therapy for refractory overactive bladder. 25% of explanted SNM devices have been shown to harbor microbes, but only 2% develop infection requiring removal. To understand the transition from the colonized (wherein bacteria are present but not pathological) to infected state, we sought to determine microbial biofilm and metabolite composition on devices, and its association with clinical factors. We hypothesized SNM devices would consistently harbor bacteria, and possess unique bacterial/metabolite profiles. METHODS: Urological patients scheduled to undergo removal or revision of SNM devices were consented per IRB-approved protocol. Devices were swabbed intraoperatively, with safeguards to avoid contamination. Swab samples, alongside controls, were subjected to next-generation sequencing and metabolomics. Association between microbial diversity and clinical variables was then analyzed using t-tests and ANOVA. RESULTS: 11 devices explanted for non-infectious reasons were included, and all harbored microbiota. Common genera included Acinetobacter, Pseudomonas, Corynebacterium, Staphylococcus, among others (Figure left). Diethanolamine (local anesthetic precursor), threonine-butyl-ester (peptide synthesis precursor), and 5-aminovaleric acid (bacterial metabolite of lysine; GABA agonist) were the most commonly detected metabolites (Figure right). There was no significant difference in bacterial diversity based on age, antibiotics, or BMI. SNM devices exhibited a unique microbial (p=0.047) and metabolomic (p=0.045) profile relative to other urologic device types (stents, sphincters, prostheses). CONCLUSIONS: Explanted devices consistently harbored microbiota and possessed a unique microbe and metabolite profile. Some of the most commonly detected microbes in the non-infected devices have been previously implicated in SNM device-associated infections (Staphylococcus, Pseudomonas). Our results open new avenues for investigation of biochemical changes occurring during the transition from colonization to clinical infection, and identify preventive strategies. Future studies will compare SNM devices explanted due to infection to those removed for other reasons to understand this pathophysiology. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e559 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Glenn T. Werneburg More articles by this author Ava Adler More articles by this author Daniel Hettel More articles by this author Sandip Vasavada More articles by this author Raymond Rackley More articles by this author Howard Goldman More articles by this author Jacqueline Zillioux More articles by this author Bradley Gill More articles by this author Daniel Shoskes More articles by this author Aaron Miller More articles by this author Expand All Advertisement PDF DownloadLoading ...