title: Detection of bacteria by fluorescence in situ hybridization in culture-negative soft tissue filler lesions.
abstract: BACKGROUND
  Adverse reactions to polyacrylamide gel occur as swellings or nodules, and controversy exists whether these are due to bacterial infection or an autoimmune reaction to the filler.
  
  
  OBJECTIVE
  Biopsies from culture-negative long-lasting nodules after injection with different types of polyacrylamide gel were examined with a combination of Gram stain and fluorescence in situ hybridization.
  
  
  RESULTS
  Bacteria were detected in biopsies from seven of eight patients. They inhabited gel and intervening tissue and tended to lie in aggregates.
  
  
  CONCLUSIONS
  This study supports the assumption that infection with bacteria in aggregates causes culture-negative late adverse reactions to polyacrylamide gel, suggesting a biofilm environment.
authors.affiliation: Department of International Health, Immunology, and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bjarnsholt
authors.forename: Tim
authors.initials: T
authors.lastname: Tolker-Nielsen
authors.forename: Michael
authors.initials: M
authors.lastname: Givskov
authors.forename: Martin
authors.initials: M
authors.lastname: Janssen
authors.forename: Lise Hanne
authors.initials: LH
authors.lastname: Christensen
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015745:Granuloma, Foreign-Body / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007267:Injections / Q000009:adverse effects; D008826:Microbial Sensitivity Tests / Q000379:methods; D012060:Rejuvenation; D015595:Skin Aging; D013203:Staphylococcal Infections / Q000175:diagnosis; D013210:Staphylococcus / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D003879:Dermatologic Agents; C016680:polyacrylamide gels