Abstract
Endoscopic stenting is a standard palliative approach for the treatment of a variety of diseases involving biliary obstruction. However, the major limitation of this approach is represented by stent occlusion followed by life-threatening cholangitis, often requiring stent removal and replacement with a new one. Although it is generally believed that microbial colonization of the inner surface of the stent plays an important role in initiating the clogging process, so far available data are not enough for a full understanding of this phenomenon. In fact, it is known that when a biliary stent is inserted across the sphincter of Oddi, the loss of the antimicrobial barrier represented by the sphincter itself and the low pressure in the common bile duct allow reflux of duodenal content, thus promoting an ascending microbial colonization. The sessile mode of growth and the exopolysaccharide production, which leads to the subsequent establishment of a thick biofilm, provides microorganisms with an efficient protection from both antibacterial agents and phagocytic cells. The aim of this study was to analyze the tridimensional structure of the microbial biofilm grown in the lumen of 15 clogged biliary stents and to identify the microbial species involved in the clogging process. Scanning electron microscopy investigations revealed that sludge present in the stent lumen consist of a rich and assorted microbial flora, including aerobic and anaerobic species, mixed with a large amount of amorphous material containing dietary fibres, crystals of cholesterol and other precipitates of bacteria-driven bile salts.
| Original language | English |
|---|---|
| Pages (from-to) | 207-209 |
| Number of pages | 3 |
| Journal | Microbial Ecology in Health and Disease |
| Volume | 20 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2008 |
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Keywords
- Biliary stent
- Biofilm
- Microbial colonization
- Stent occlusion
ASJC Scopus subject areas
- Microbiology (medical)
- Microbiology
Cite this
Role of multispecies microbial biofilms in the occlusion of biliary stents. / Guaglianone, Emilio; Cardines, Rita; Mastrantonio, Paola; Rosa, Roberta Di; Penni, Adriano; Puggioni, Gianluca; Basoli, Antonio; Fiocca, Fausto; Donelli, Gianfranco.
In: Microbial Ecology in Health and Disease, Vol. 20, No. 4, 2008, p. 207-209.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Role of multispecies microbial biofilms in the occlusion of biliary stents
AU - Guaglianone, Emilio
AU - Cardines, Rita
AU - Mastrantonio, Paola
AU - Rosa, Roberta Di
AU - Penni, Adriano
AU - Puggioni, Gianluca
AU - Basoli, Antonio
AU - Fiocca, Fausto
AU - Donelli, Gianfranco
PY - 2008
Y1 - 2008
N2 - Endoscopic stenting is a standard palliative approach for the treatment of a variety of diseases involving biliary obstruction. However, the major limitation of this approach is represented by stent occlusion followed by life-threatening cholangitis, often requiring stent removal and replacement with a new one. Although it is generally believed that microbial colonization of the inner surface of the stent plays an important role in initiating the clogging process, so far available data are not enough for a full understanding of this phenomenon. In fact, it is known that when a biliary stent is inserted across the sphincter of Oddi, the loss of the antimicrobial barrier represented by the sphincter itself and the low pressure in the common bile duct allow reflux of duodenal content, thus promoting an ascending microbial colonization. The sessile mode of growth and the exopolysaccharide production, which leads to the subsequent establishment of a thick biofilm, provides microorganisms with an efficient protection from both antibacterial agents and phagocytic cells. The aim of this study was to analyze the tridimensional structure of the microbial biofilm grown in the lumen of 15 clogged biliary stents and to identify the microbial species involved in the clogging process. Scanning electron microscopy investigations revealed that sludge present in the stent lumen consist of a rich and assorted microbial flora, including aerobic and anaerobic species, mixed with a large amount of amorphous material containing dietary fibres, crystals of cholesterol and other precipitates of bacteria-driven bile salts.
AB - Endoscopic stenting is a standard palliative approach for the treatment of a variety of diseases involving biliary obstruction. However, the major limitation of this approach is represented by stent occlusion followed by life-threatening cholangitis, often requiring stent removal and replacement with a new one. Although it is generally believed that microbial colonization of the inner surface of the stent plays an important role in initiating the clogging process, so far available data are not enough for a full understanding of this phenomenon. In fact, it is known that when a biliary stent is inserted across the sphincter of Oddi, the loss of the antimicrobial barrier represented by the sphincter itself and the low pressure in the common bile duct allow reflux of duodenal content, thus promoting an ascending microbial colonization. The sessile mode of growth and the exopolysaccharide production, which leads to the subsequent establishment of a thick biofilm, provides microorganisms with an efficient protection from both antibacterial agents and phagocytic cells. The aim of this study was to analyze the tridimensional structure of the microbial biofilm grown in the lumen of 15 clogged biliary stents and to identify the microbial species involved in the clogging process. Scanning electron microscopy investigations revealed that sludge present in the stent lumen consist of a rich and assorted microbial flora, including aerobic and anaerobic species, mixed with a large amount of amorphous material containing dietary fibres, crystals of cholesterol and other precipitates of bacteria-driven bile salts.
KW - Biliary stent
KW - Biofilm
KW - Microbial colonization
KW - Stent occlusion
UR - http://www.scopus.com/inward/record.url?scp=57649116094&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57649116094&partnerID=8YFLogxK
U2 - 10.1080/08910600802408145
DO - 10.1080/08910600802408145
M3 - Article
AN - SCOPUS:57649116094
VL - 20
SP - 207
EP - 209
JO - Microbial Ecology in Health and Disease
JF - Microbial Ecology in Health and Disease
SN - 0891-060X
IS - 4
ER -