Biofilms on Indwelling Artificial Urinary Sphincter Devices Harbor Complex Microbe-Metabolite Interaction Networks...

Area of Science:

• Urology
• Infectious Diseases
• Biomaterials Science

Background:

• Artificial urinary sphincter (AUS) devices effectively treat incontinence but are susceptible to infection.
• Device-associated infections necessitate explantation and impact patient quality of life.

Purpose of the Study:

• To comprehensively characterize the microbial and metabolic composition of biofilms on explanted AUS devices.
• To identify key microbial players and their interactions within AUS biofilms.
• To inform the development of novel prevention and treatment strategies for AUS infections.

Main Methods:

• Biofilm samples were collected from explanted AUS devices.
• Next-generation sequencing and metabolomics were employed for comprehensive analysis.
• Microbial strains were isolated and their biofilm formation studied in a bioreactor model.

Main Results:

• All eighteen explanted AUS devices harbored microbial biofilms.
• Staphylococcus, Escherichia/Shigella, and Methylobacterium-Methylorubrum were central genera in the microbe-metabolite interaction network.
• A rifampin resistance mutation was detected in 53% of biofilms, and Staphylococcus warneri showed increased biofilm formation on polyurethane.

Conclusions:

• AUS device infections are characterized by complex microbial biofilms with significant metabolic activity.
• The identified microbial composition and resistance patterns provide a basis for targeted antimicrobial strategies.
• Further research into biofilm inhibitors and material science is warranted to reduce AUS device infections.