Detection of Bacteria by Fluorescence in Situ Hybridization in Culture-Negative Soft Tissue Filler Lesions

Abstract

This study supports the assumption that infection with bacteria in aggregates causes culture-negative late adverse reactions to polyacrylamide gel, suggesting a biofilm environment.

Pathology and Biofilm Formation in a Porcine Model of Staphylococcal Osteomyelitis

“…The aggregation of bacteria was similar to previous observations in chronic biofilm-based infections such as cystic fibrosis (Bjarnsholt et al, 2009a), chronic wounds (Bjarnsholt et al, 2008) and infections related to permanent tissue fillers (Bjarnsholt et al, 2009b). Therefore, and in accordance with the presence of granulation tissue, the osteomyelitis lesions of the pigs developed into a pathological and microbiological chronic stage shortly after infection.…”

The Limitations of In Vitro Experimentation in Understanding Biofilms and Chronic Infection

“…Lying completely surrounded by immune cells, mainly PMNs, these aggregates range in size from 4 µm -100 µm in diameter [3,20]. The same mode of non-attached aggregated biofilm growth have been observed in other types of infection, such as those found in chronic wounds, otitis media, and soft tissue fillers [4,5,61].…”

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

“…[23][24][25] Biofilms are usually not identifiable by culture and may appear as sterile abscesses or cause a chronic inflammatory response. 26,27 Histologically, inflammatory reactions to HA injection have shown both lymphoplasmacytic and lymphocytic-macrophage infiltrates with foreignbody granulomas. 6 The appearance of inflammatory nodules in areas located at some distance from the injection site, the course of the reaction (waxing and waning), the resistance of lesions to long-term antibiotic treatment, and the negative bacterial culture and PCR assay (in 1 patient, before antibiotic treatment) are less compatible with biofilm formation and favor an immunogenic reaction as the mechanism underlying reaction to HAVb.…”