title: Biomaterial-associated persistence of Staphylococcus epidermidis in pericatheter macrophages.
abstract: Biomaterial surfaces may be modified to reduce bacterial adhesion. The susceptibility in mice to Staphylococcus epidermidis infection in tissue surrounding the commonly used catheter materials-silicon elastomer (SE), polyamide (PA), and their surface-modified polyvinylpyrrolidone (PVP)-grafted derivatives, SE-PVP and PA-PVP, respectively-was assessed. Abscesses developed around SE-PVP. Around SE, PA, and PA-PVP catheters, no signs of infection were observed, although mice carrying PA-PVP developed septicemia after 14-21 days. S. epidermidis was cultured from the tissue surrounding PA-PVP segments. Cells around PA-PVP segments containing large numbers of bacteria were identified as macrophages by use of immunohistochemistry and electron microscopy. This persistence of intracellular bacteria was also observed around SE-PVP, SE, and PA catheters, although to a lesser extent. The cytokine profiles around the 4 materials were different. Implanted biomaterial induces an inflammatory response favorable to the persistence of S. epidermidis. Intracellular persistence of bacteria inside macrophages may be a pivotal process in the pathogenesis of biomaterial-associated infection.
authors.affiliation: Dept. of Pediatrics, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. Boelensjj@yahoo.com
authors.forename: J J
authors.initials: JJ
authors.lastname: Boelens
authors.forename: J
authors.initials: J
authors.lastname: Dankert
authors.forename: J L
authors.initials: JL
authors.lastname: Murk
authors.forename: J J
authors.initials: JJ
authors.lastname: Weening
authors.forename: T
authors.initials: T
authors.lastname: van der Poll
authors.forename: K P
authors.initials: KP
authors.lastname: Dingemans
authors.forename: L
authors.initials: L
authors.lastname: Koole
authors.forename: J D
authors.initials: JD
authors.lastname: Laman
authors.forename: S A
authors.initials: SA
authors.lastname: Zaat
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000209:etiology*; D001422:Bacterial Adhesion; D001672:Biocompatible Materials; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D005260:Female; D007249:Inflammation / Q000382:microbiology; D007371:Interferon-gamma / Q000096:biosynthesis; D007375:Interleukin-1 / Q000096:biosynthesis; D016753:Interleukin-10 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D008264:Macrophages / Q000382:microbiology*; D051379:Mice; D008810:Mice, Inbred C57BL; D009757:Nylons; D011205:Povidone; D012826:Silicone Elastomers; D013203:Staphylococcal Infections / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification / Q000502:physiology*; D013499:Surface Properties; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
chemical_list: D001672:Biocompatible Materials; D007375:Interleukin-1; D015850:Interleukin-6; D009757:Nylons; D012826:Silicone Elastomers; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma; D011205:Povidone