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Updated: Mar 23, 2026

Bile Salt-induced Biofilm Formation in Enteric Pathogens: Techniques for Identification and Quantification
Published on: May 6, 2018
Biofilms associated with bowel necrosis: A newly recognised phenomenon in infants
Giulia Brisighelli1, Sharon Cox, Andre Theron
1UOC Chirurgia Pediatrica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. giuliabrisighelli@gmail.com.
Background:
A biofilm is defined as a collection of organisms attached to a surface and surrounded by a matrix.
Objective:
To present three cases in which bowel necrosis coexisted with biofilm.
Methods:
The medical records, bacteriological findings and tissue biopsies from three infants with bowel necrosis who subsequently died from sepsis were analysed. Tissue sent for histological evaluation was prepared for light microscopy. Haematoxylin and eosin (H&E), Sandiford and Alcian blue/periodic acid Schiff (ABPAS) stains were performed. Tissue samples were ex-waxed for electron microscopy in one case.
Results:
The three patients described all had necrotic bowel at laparotomy, all cultured Klebsiella pneumoniae from peritoneal pus swabs, and all died despite appropriate antibiotics. All specimens showed varying degrees of bowel necrosis and an organising acute peritoneal reaction. In addition, all showed colonies of Gram-negative bacteria within a mucopolysaccharide matrix.
Conclusions:
The identification of biofilms in necrotic bowel has raised questions regarding their clinical implications. Further studies are needed to evaluate all resected necrotic bowel for biofilms and the clinical implications of this finding.
Insights
Biofilms were identified in the necrotic bowel tissue of three infants who died from sepsis. This finding suggests a potential link between biofilms and severe intestinal complications in neonates.
Area of Science:
- Microbiology
- Pathology
- Neonatal Medicine
Background:
- Biofilms are microbial communities encased in a matrix, adhering to surfaces.
- Understanding biofilm formation is crucial in various medical contexts.
Observation:
- Three infant cases of bowel necrosis were analyzed.
- Bowel necrosis was associated with sepsis and mortality despite antibiotic treatment.
Findings:
- Klebsiella pneumoniae was cultured from peritoneal pus in all cases.
- Histological examination revealed Gram-negative bacteria within a mucopolysaccharide matrix in necrotic bowel tissue.
- Biofilm presence was confirmed in necrotic bowel specimens.
Implications:
- The clinical significance of biofilms in bowel necrosis requires further investigation.
- Routine evaluation of resected necrotic bowel for biofilms may be warranted.
- This research highlights a potential factor in neonatal sepsis and intestinal failure.
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