Colonies of bacterial biofilms are thought to play a role in prompting an autoimmune response in patients who have been implanted with polypropylene mesh.
Montana State, UC Berkeley, and Stanford University are among the schools who have biofilm centers studying this scientific phenomenon that has been emerging over the last two decades.
The University of California Los Angeles (UCLA) is focusing their studies on the occurrence of biofilms on mesh explants.
It’s theorized that almost all bacteria live in a community and attach to biofilms. Biofilms are a protective coating that makes mesh implants resistant to treatment with antibiotics. About eighty percent of infections are related to bacterial biofilms.
In order to survive, they cluster. UC Berkeley scientists believe the biofilms of bacteria are about one-thousand times more resistant to antibiotics than a single bacteria.
Biofilm formation is common on most polymeric materials and it thrives in high humidity.
One theory is that a transvaginal placement (insertion through the vagina) of pelvic mesh leads to a higher likelihood of contamination that may result in bacterial biofilms, which form on the mesh of susceptible individuals. Over time, an infection may override the body’s immune system leading to a long-term reaction to the mesh implant.
Occasionally the biofilms are believed to shed their bacteria, which can result in acute infections and fever, as well as an elevated white blood cell count. While an antibiotic may kill off the infection, the bacteria that lives in clusters on the biofilm may remain untouched.
Many women implanted with mesh report rashes, fibromyalgia, Lupus, joint pain, chronic fatigue, systemic issues, among other complications. There are so many cases of medical issues associated with biofilms that UCLA researchers believe there may be a connection and are studying the complications of biofilms as they relate to mesh explants.
The UCLA Department of Urology is one of the largest in the world for treating women with mesh complications that lead to removal.
Research conducted at U.C. Berkeley two years ago used a super-resolution light microscopy to see the bacterial colonies and their protective biofilm coating.
The sensitive microscope showed that within six hours, a single bacterium can create a cluster. The mass then secretes a glue-like protein creating a protective shell or film. The different colored dyes applied to the biofilm show a world of strange fluorescent globules that create a protective colony of sticky biofilm around the bacteria.
The tenacious bacteria and its coating are linked to lung infections in cystic fibrosis patients, chronic sinusitis, and cholera. These infections are not uncommon around medical device implants including pacemakers, joints, stents and plastic mesh for hernia and pelvic organ prolapse.
In order to treat the infections most biofilms have to be removed surgically. Researchers hope to find a less invasive treatment. The goal of this treatment is to attack the protein so that the bacterial coating can be dissolved without a surgery to remove the entire biofilm. Probiotics may be an answer to help fight biofilms and baking soda promotes detachment because it is alkaline, which hydrolyzes the surface.
Preventing attachment of the bacteria to the surface and avoiding these complications in the first place is a far more appealing strategy for anyone fighting a chronic infection from a permanently implanted medical device.
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