Skin bacterial flora as a potential risk factor predisposing to late bacterial infection after cross-linked hyaluronic acid gel augmentation

Netsvyetayeva, I.; Marusza, Wojciech; Olszański, Romuald; Szyller, Kamila; Krolak-Ulinska, Aneta; Swoboda-Kopeć, Ewa; Sierdziński, Janusz; Szymonski, Zachary; Młynarczyk, G.

doi:10.2147/idr.s154328

Cited by 20 publications

(16 citation statements)

References 25 publications

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“…Two studies did not detect any bacteria in the collected samples [19,33]. The (mainly Staphylococcus epidermidis) and Propionibacterium acnes, which were detected in up to 98% of positive cultures, and which lead to the hypothesis that the presence of these bacteria is involved in development of LIRs [7,8,24,28,31,32]. Two studies compared bacterial presence in samples from patients with adverse events and patient with no adverse events, both finding a much higher rate of bacteria in the adverse events' group [7,24].…”

Section: Discussion Bacterial Contamination and Lirsmentioning

confidence: 99%

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

Bachour

Kadouch²,

Niessen

2021

Aesth Plast Surg

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Background Late inflammatory reactions (LIRs) are the most challenging complications after filler use. The immune system plays a prominent role in its etiology, albeit to an unknown extent. Bacterial contamination in situ has been hypothesized to be causative for LIRs. How this relates to the immunological processes involved is unknown. This article aims to provide an overview of immunological and bacterial factors involved in development of LIRs. Methods We undertook a systematic literature review focused on immunological factors and microbiota in relation to LIRs after filler use. This systematic review was performed in accordance with the PRISMA guidelines. PubMed, EMBASE and the Cochrane databases were searched from inception up to August 2019. Included studies were assessed for the following variables: subject characteristics, number of patients, primary indication for filler injection, implant type/amount and injection site, type of complication, follow-up or injection duration, study methods, type of antibiotics or medical therapies and outcomes related to microbiota and immunological factors. Results Data on immunological factors and bacterial contamination were retrieved from 21 included studies. Notably, the presence of histocytes, giant cells and Staphylococcus epidermidis within biopsies were often associated with LIRs. Conclusion This review provides a clear overview of the immunological factors associated with LIRs and provides a hypothetical immunological model for development of the disease. Furthermore, an overview of bacterial contamination and associations with LIRs has been provided. Follow-up research may result in clinical recommendations to prevent LIRs. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors-www.springer.com/00266..

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Section: Discussion Bacterial Contamination and Lirsmentioning

confidence: 99%

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

Bachour

Kadouch²,

Niessen

2021

Aesth Plast Surg

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“…The observed repellency to VOCs produced by C. koseri may be understood if the natural occurrence of the bacterium is considered: C. koseri is a gram-negative bacillus of the family Enterobacteriaceae commonly found in animal intestines, soils, water, sewage and contaminated food, and it is widely recognized for causing devastating meningitis in neonates and severe infections in immunosuppressed patients [48]. This bacterium is not part of the healthy human skin microbiota; human skin isolations where this bacillus is found are commonly from sick patients [48,49] so that, these volatiles could signal an unhealthy individual to the bugs.…”

Section: Discussionmentioning

confidence: 99%

Novel repellents for the blood-sucking insects Rhodnius prolixus and Triatoma infestans, vectors of Chagas disease

et al. 2020

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Background: Studying the behavioral response of blood-sucking disease-vector insects to potentially repellent volatile compounds could shed light on the development of new control strategies. Volatiles released by human facial skin microbiota play different roles in the host-seeking behavior of triatomines. We assessed the repellency effect of such compounds of bacterial origin on Triatoma infestans and Rhodnius prolixus, two important vectors of Chagas disease in Latin America. Methods: Using an exposure device, insects were presented to human odor alone (control) and in the presence of three individual test compounds (2-mercaptoethanol, dimethyl sulfide and 2-phenylethanol, the latter only tested in R. prolixus) and the gold-standard repellent NN-diethyl-3-methylbenzamide (DEET). We quantified the time the insects spent in the proximity of the host and determined if any of the compounds evaluated affected the behavior of the insects. Results: We found volatiles that significantly reduced the time spent in the proximity of the host. These were 2-phenylethanol and 2-mercaptoethanol for R. prolixus, and dimethyl sulfide and 2-mercaptoethanol for T. infestans. Such an effect was also observed in both species when DEET was presented, although only at the higher doses tested. Conclusions: The new repellents modulated the behavior of two Chagas disease vectors belonging to two different triatomine tribes, and this was achieved using a dose up to three orders of magnitude lower than that needed to evoke the same effect with DEET. Future efforts in understanding the mechanism of action of repellent compounds such as 2-mercaptoethanol, as well as an assessment of their temporal and spatial repellent properties, could lead to the development of novel control strategies for these insect vectors, refractory to DEET.

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“…The introduction of probiotics into the scheme was justified by the results of our previous study, which showed that treatment with physiological skin flora decreased the risk of LBI after cross-linked HA administration 28. We are aware that our choice of probiotics was not perfect for ensuring an appropriate composition of the physiological skin flora during and after empirical broad-spectrum antibiotic usage.…”

Section: Discussionmentioning

confidence: 99%

<p>Treatment of late bacterial infections resulting from soft-tissue filler injections</p>

Marusza¹,

Olszański

Sierdziński

et al. 2019

IDR

Self Cite

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Purpose Late bacterial infections (LBIs) after esthetic facial augmentation using hyaluronic acid (HA) fillers are relatively rare yet severe complications that are difficult to treat. No adequate treatment standards have hitherto been formulated. We have bridged this gap by formulating a treatment scheme based on the principles of treating foreign-body implantation-related infections and treating bacterial growth in the form of biofilm. The objective of this study was to evaluate the efficacy of a comprehensive scheme for treating LBI complications after facial augmentation using cross-linked HA fillers. Methods A total of 22 patients with LBI symptoms at a site of cross-linked HA injection underwent treatment and observation. The comprehensive treatment scheme formulated by Marusza and Netsvyetayeva (M&N scheme) comprised draining the lesion, dissolution of cross-linked HA with hyaluronidase, broad-spectrum antibiotic combination therapy, and use of probiotics. While 17 patients underwent the M&N scheme, the remaining five were treated with other schemes. Statistical analysis of the data was performed using Mann–Whitney U and χ 2 nonparametric tests with SAS 9.4 software. Results All 17 patients who underwent the M&N scheme experienced resolution of symptoms, with no recurrence of infection at the HA-injection sites. Conclusion To treat LBI at a site of cross-linked HA administration, the principles applicable to infections resulting from implantation of a foreign body must be followed. The treatment period should be sufficiently long for complete resolution of symptoms. The efficacy of treatment is considered proven if 2 months have elapsed without recurrence since the symptoms resolved. The M&N scheme is recommended for use as the first therapeutic option for treating LBI related to soft-tissue fillers.

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Skin bacterial flora as a potential risk factor predisposing to late bacterial infection after cross-linked hyaluronic acid gel augmentation

Cited by 20 publications

References 25 publications

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

Novel repellents for the blood-sucking insects Rhodnius prolixus and Triatoma infestans, vectors of Chagas disease

<p>Treatment of late bacterial infections resulting from soft-tissue filler injections</p>

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