title: Bacterial biofilm within diseased pancreatic and biliary tracts.
abstract: BACKGROUND
  Bacterial community structures in human pancreatic and biliary tracts were evaluated.
  
  
  METHODS
  Gall bladder stones from 153 patients, 20 gall bladder walls, six common duct stones, 52 biliary stents, 21 duodenal biopsies, nine pancreatic duct biopsies, and five bile ducts were investigated using fluorescence in situ hybridisation (FISH) with ribosomal RNA targeted Cy3/Cy5 (carbocyanine) labelled oligonucleotide probes.
  
  
  RESULTS
  Duodenal, gall bladder, and bile duct walls were free of bacteria. A dense multispecies bacterial biofilm was present within the pancreatic duct of patients with calcific pancreatitis and within biliary stents, irrespective of diagnosis. The concentration, density, and amenability of the biofilm to FISH and DNA staining declined progressively with the grade of stent occlusion. The lowest detectable bacterial concentrations were found by FISH in completely occluded stents and brown/mixed gall stones. Bacteria were not detectable with FISH in cholesterol gall stones.
  
  
  CONCLUSIONS
  A wide range of different branches and groups of bacteria participate in the development of biofilms on the surfaces of foreign bodies, such as biliary stents, mixed gall stones, or calcific pancreatic ducts, but not on the surface of pure cholesterol gall stones. Occlusion of stents leads to progressive extinction of the biofilm and mummification of its components. Deposition of cholesterol or other substances within the biofilm matrix may be a novel mechanism of host defence against bacteria present in these biofilms.
authors.affiliation: Innere Klinik, Gastroenterologie, Charité, 10098 Berlin, Germany. alexander.swidsinski@charite.de
authors.forename: A
authors.initials: A
authors.lastname: Swidsinski
authors.forename: P
authors.initials: P
authors.lastname: Schlien
authors.forename: A
authors.initials: A
authors.lastname: Pernthaler
authors.forename: U
authors.initials: U
authors.lastname: Gottschalk
authors.forename: E
authors.initials: E
authors.lastname: Bärlehner
authors.forename: G
authors.initials: G
authors.lastname: Decker
authors.forename: S
authors.initials: S
authors.lastname: Swidsinski
authors.forename: J
authors.initials: J
authors.lastname: Strassburg
authors.forename: V
authors.initials: V
authors.lastname: Loening-Baucke
authors.forename: U
authors.initials: U
authors.lastname: Hoffmann
authors.forename: D
authors.initials: D
authors.lastname: Seehofer
authors.forename: L P
authors.initials: LP
authors.lastname: Hale
authors.forename: H
authors.initials: H
authors.lastname: Lochs
mesh_terms: D001419:Bacteria / Q000302:isolation & purification; D001652:Bile Ducts / Q000382:microbiology*; D018441:Biofilms; D002769:Cholelithiasis / Q000382:microbiology*; D002784:Cholesterol / Q000502:physiology; D002908:Chronic Disease; D004386:Duodenum / Q000382:microbiology; D004866:Equipment Contamination; D005704:Gallbladder / Q000382:microbiology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D010183:Pancreatic Ducts / Q000382:microbiology*; D010195:Pancreatitis / Q000382:microbiology*; D011475:Prosthesis Failure; D015607:Stents / Q000382:microbiology
chemical_list: D002784:Cholesterol