You have accessJournal of UrologyCME1 Apr 2023MP62-08 PENILE PROSTHESIS BIOFILMS: A PARADIGM SHIFT FROM INFECTION TO COLONIZATION Glenn Werneburg, Scott Lundy, Daniel Hettel, Petar Bajic, Bradley Gill, Ava Adler, Sromona Mukherjee, Hadley Wood, Kenneth Angermeier, Daniel Shoskes, and Aaron Miller Glenn WerneburgGlenn Werneburg More articles by this author , Scott LundyScott Lundy More articles by this author , Daniel HettelDaniel Hettel More articles by this author , Petar BajicPetar Bajic More articles by this author , Bradley GillBradley Gill More articles by this author , Ava AdlerAva Adler More articles by this author , Sromona MukherjeeSromona Mukherjee More articles by this author , Hadley WoodHadley Wood More articles by this author , Kenneth AngermeierKenneth Angermeier 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.0000000000003320.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The penile prosthesis is an effective erectile dysfunction treatment, but a subset of devices develops infection or pain requiring explant. To understand differences between asymptomatic colonized and infected states, we sought to determine penile prosthesis biofilm composition, microbe-metabolite interaction networks, and association with clinical factors. METHODS: Patients scheduled for penile prosthesis removal/revision were included. Devices were swabbed upon initial access. Samples and experimental controls underwent next-generation sequencing, metabolomics, and culture-based assessments with appropriate controls. Clinical factor association was analyzed with t-tests and ANOVA. Isolates were cultured from devices, and biofilm formation was reconstituted in a continuous-flow stir tank bioreactor. RESULTS: Of 27 devices explanted and analyzed, 4 were explanted for infection and 4 for pain. 93% of all devices harbored a demonstrable biofilm. Seven genera including Faecalibaculum (log2 fold change +4.10, p<0.001), Jeotgalicoccus (+3.22, p<0.001), and Nosocomiicoccus (+2.94, p<0.001) were more abundant in infected than uninfected device biofilms. Eight microbial genera were more abundant in the presence of pain. Smokers and those with diabetes mellitus or cardiac disease had lower total normalized microbial counts than those without the conditions (p<0.001). We identified multiple microbe-metabolite interaction networks and subnetworks enriched in devices explanted for infection and pain. Biofilm formation by multiple microbial strains was recapitulated on relevant materials including silicone, PTFE, polyurethane, and titanium in vitro to facilitate further mechanistic studies. CONCLUSIONS: Even in the absence of infection, nearly all penile prosthesis devices harbor robust biofilms. Staphylococcus and Escherichia, the most commonly reported causative organisms of infection using traditional culture techniques, had similar abundance irrespective of infection status. A series of other uncommon genera and metabolites were differentially abundant, suggesting a complex microbe-metabolite pattern – rather than a single rogue organism – is responsible for the transition from the asymptomatic to the infected or pain state. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e864 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Glenn Werneburg More articles by this author Scott Lundy More articles by this author Daniel Hettel More articles by this author Petar Bajic More articles by this author Bradley Gill More articles by this author Ava Adler More articles by this author Sromona Mukherjee More articles by this author Hadley Wood More articles by this author Kenneth Angermeier More articles by this author Daniel Shoskes More articles by this author Aaron Miller More articles by this author Expand All Advertisement PDF downloadLoading ...
Read full abstract