Bile glycoprotein mucin in sludge occluding biliary stent

Zhang, Hongjun; Tsang, Tat-Kin; Jack, Christy A.

doi:10.1016/s0022-2143(03)00087-8

Cited by 20 publications

(16 citation statements)

References 44 publications

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“…This work identified 51 distinct bacterial phylotypes belonging to 5 bacterial phyla and 24 families from stent microbial communities revealing a greater diversity of bacteria compared with earlier studies (Speer et al, 1988;Dowidar et al, 1991;Molinari et al, 1996;Di Rosa et al, 1999;Leung et al, 2000;Zhang et al, 2003). These six former studies collectively identified members of 23 bacterial genera (but only 16 families) from 138 stents using cultivation approaches and usually indicated Gramnegative facultative anaerobic g-Proteobacteria (predominantly Enterobacteriaceae comprising 455% of isolates) and Gram-positive facultative anaerobic 'Bacilli' (comprising 430% of isolates) as predominant.…”

Section: Discussionmentioning

confidence: 52%

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Characterization of the complex bacterial communities colonizing biliary stents reveals a host-dependent diversity

et al. 2009

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This study provides a comprehensive survey of the spatial and temporal bacterial composition of biliary stent biofilms. The bacterial diversity, distribution and dynamics of 59 biliary and 4 pancreatic stent communities from 40 patients being treated at two different hospitals, which implant stents either simultaneously or consecutively, were characterized by single-strand conformation polymorphism (SSCP) analysis. Fifty-one phylotypes belonging to 5 bacterial phyla and 24 bacterial families were detected across 63 stents. This is a much broader diversity than previously detected through culture-dependent methods, particularly in regard to the diversity of obligate anaerobes. Stent bacterial diversity was patient-dependent and more similar when stents were implanted simultaneously rather than consecutively. Stent bacterial community composition differed between hospitals specifically because of the difference in abundance of Bifidobacteria. Co-colonization of Veillonella sp., Streptococcus anginosus and organisms closely related to Fusobacterium nucleatum revealed a potentially important attachment and survival strategy that has yet to be reported in biliary stents. This work reveals a more complete survey of the identities of bacterial species that form biofilms in biliary stents, their co-colonization patterns and the natural variation in species composition between different patients, hospitals and locations along the stent. Consideration of the community composition from individual patients will allow tailoring of prophylactic antibiotic treatments and thus will make the management of stent biofilms more effective.

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Section: Discussionmentioning

confidence: 52%

“…(phylotype 34, observed in 66% of samples, see Figure 1 (Speer et al, 1988;Dowidar et al, 1991;Molinari et al, 1996;Di Rosa et al, 1999;Zhang et al, 2003;Cole et al, 2007).…”

Section: Stent Bacterial Diversitymentioning

confidence: 99%

Characterization of the complex bacterial communities colonizing biliary stents reveals a host-dependent diversity

et al. 2009

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“…Bile glycoprotein mucin, shown to line the inner surface of occluded stents, has also been proposed to affect bacterial adherence acting as a cement among water insoluble compounds, such as bilirubin and bacterial clumps. 36 Electron microscopy observations of occluded stents have shown that clogging material, the so-called biliary sludge, is mainly formed by the accumulation of multispecies microbial colonies growing in sessile mode, microbial byproducts, and crystals of calcium bilirubinate and calcium palmitate. Within this complex, large plant fibers arising from duodenal reflux have been observed as constituents of intraluminal networks contributing to stent clogging.…”

Section: Causative Factors and Dynamics Of The Clogging Process In Plmentioning

confidence: 99%

“…38 Microorganisms isolated from occluded biliary stents include both aerobic and anaerobic bacterial species, as well as fungi (table 1). 28,36,[39][40][41] The Gram-positive Enterococcus species and Gram-negatives Escherichia coli and Klebsiella species are the most common aerobic bacteria isolated from biliary sludge, while Clostridium species are the prevalent anaerobes. However, the ratio between aerobic and anaerobic species, as well as all isolated species, varies in different studies, presumably depending on either the portion (proximal, median or distal) of the stent analyzed or the delay in performing microbiological analysis after stent removal.…”

Section: Causative Factors and Dynamics Of The Clogging Process In Plmentioning

confidence: 99%

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Plastic Biliary Stent Occlusion: Factors Involved and Possible Preventive Approaches

Donelli

Guaglianone

Rosa

et al. 2007

Clinical Medicine & Research

141

114

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Feasibility evaluation of chitosan coatings on polyethylene tubing for biliary stent applications

Lin

Chen

et al. 2005

J of Applied Polymer Sci

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Endoscopic palliation for the obstructive jaundice caused by biliary or pancreatic malignant tumors is a commonly used medical treatment. However, plastic biliary stents are occluded by sludge deposition caused by bacterial adhesion in 3-5 months. Chitosan, which has both good biocompatibility and antimicrobial capability, was used to modify the inner surface of polyethylene (PE) tubing in this study. Chitosan was deposited onto the inner surface of oxidized PE tubing with the methanol precipitation technique. Attenuated total reflection/Fourier transform infrared and electron spectroscopy for chemical analysis indicated that the chitosan coating was feasible. Contact-angle measurements revealed that the surface hydrophilicity of the PE tubing increased with the chitosan coating. Morphological analysis with scanning electron microscopy showed that the PE surface became rougher and exhibited micropores after the chitosan coating. The adhesion of living Escherichia coli to chitosan-coated PE stents, characterized by the spreading plate method and scanning electron microscopy analysis, was more significant than that to unmodified stents after a 24-h phosphate-buffered saline or bile perfusion test. This finding may be attributed to the rougher and slightly positively charged surface of chitosan-coated PE tubing and to the OCH 3 hydrophobic functional groups in the chitosan structure. Because of its good biocompatibility, chitosan coated on the surface of PE can still be used for biliary stent applications with further chemical modification, such as sulfonation and quaternization, to increase its antimicrobial ability.

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Bile glycoprotein mucin in sludge occluding biliary stent

Cited by 20 publications

References 44 publications

Characterization of the complex bacterial communities colonizing biliary stents reveals a host-dependent diversity

Characterization of the complex bacterial communities colonizing biliary stents reveals a host-dependent diversity

Plastic Biliary Stent Occlusion: Factors Involved and Possible Preventive Approaches

Feasibility evaluation of chitosan coatings on polyethylene tubing for biliary stent applications

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