Detection of bacteria by fluorescence in situ hybridization in culture-negative soft tissue filler lesions.
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.
Bjarnsholt
Thomas
T
Department of International Health, Immunology, and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Tolker-Nielsen
Tim
T
Givskov
Michael
M
Janssen
Martin
M
Christensen
Lise Hanne
LH
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
D000180:Acrylic Resins; D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D003879:Dermatologic Agents; C016680:polyacrylamide gels