Are bacterial growth and/or chemotaxis increased by filler injections? Implications for the pathogenesis and treatment of filler-related granulomas.
BACKGROUND
As microbial agents have been associated with late adverse effects related to fillers antibiotic treatment has been envisaged.


OBJECTIVE
To determine whether biomaterials favor bacterial growth and/or attract bacteria.


METHODS
Hyaluronic acid, semi-permanent fillers, such as calcium hydroxylapatite, and permanent fillers, such as polyalkylimide/polyacrylamide, were used. Experiments were performed with Escherichia coli, strain HVH-U47. Bacteria were transferred to Sven-Gard agar to test mobility. Striae of this bacterial strain with a MacFarland 1 turbulence pattern were seeded from a spot of inoculated biomaterial using Müller-Hinton medium. The chemoattractive properties of the biomaterials were analyzed 10 days after inoculation. Bacterial growth over the biomaterial and in-depth growth were assessed as well.


RESULTS
Semi-permanent fillers did not stimulate bacterial growth but they allowed bacterial colonization over the filler. Permanent acrylic compounds neither presented chemoattractant properties nor showed bacterial growth over the biomaterial. Similar results were obtained when performing in-depth cultures.


CONCLUSIONS
Permanent and semi-permanent fillers did not facilitate bacterial growth when flagellated E. coli HVH-U47 was used. Our results do not argue in favor of antibiotics as the mainstay of therapy in late granulomas related to permanent fillers. In the case of resorbable/semi-permanent fillers, more studies are needed before recommending antibiotic therapy.
Systemic Autoimmune Disease Unit, Department of Internal Medicine I, Aging Basic Research Group, Molecular Biology and Biochemistry Research Center for Nanomedicine, CIBBIM-Nanomedicine, Vall Hebron University Hospital, Barcelona, Spain. jalijotase@vhebronet.net
Jaume
J
Alijotas-Reig
Francesc
F
Miró-Mur
Irene
I
Planells-Romeu
Natalia
N
Garcia-Aranda
Victor
V
Garcia-Gimenez
Miquel
M
Vilardell-Tarrés
D000180:Acrylic Resins / Q000008:administration & dosage*; D001672:Biocompatible Materials / Q000008:administration & dosage; D002633:Chemotaxis; D003357:Cosmetic Techniques / Q000009:adverse effects; D017886:Durapatite / Q000008:administration & dosage*; D004926:Escherichia coli / Q000254:growth & development*; D015745:Granuloma, Foreign-Body / Q000382:microbiology*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007271:Injections, Intradermal / Q000009:adverse effects; D019736:Prostheses and Implants / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000382:microbiology; D000099166:Polyacrylamides
D000180:Acrylic Resins; D001672:Biocompatible Materials; D017886:Durapatite; D006820:Hyaluronic Acid; D000099166:Polyacrylamides