In vivo Analysis of the Resistance of the Meshes to Escherichia coli Infection

Abstract

Background: The mesh infection is mostly related to the gram-negative bacteria, such as Escherichia coli (E. coli) for emergency surgery of incarcerated hernia. However, few study investigated the effects of E. coli concentration, mesh materials and antibiotic prophylaxis on mesh infection after hernioplasty. The aim of this study was to evaluate the bacterial resistance to E. coli for three different materials of mesh, and to measure the minimum E. coli concentration for mesh infection with and without antibiotic prophylaxis in a rat model.Methods: Three types of mesh (polytetrafluoroethylene, polypropylene, and biologic meshes) were used in the repair of an acute ventral hernia rat model in the setting of different concentrations of E. coli loads and antibiotics. At the 8th day after surgery, mesh samples were sent for microbiologic and histologic analyses.Results: The positive rates of bacterial culture increased with E. coli concentration. The biologic mesh showed better bacterial resistance compared to polytetrafluoroethylene mesh and polypropylene mesh when the concentration of E. coli ranges from 106 CFU/ml to 108 CFU/ml (P = 0.002 and P = 0.029, respectively). Prophylactical ceftriaxone treatment could not decrease the colonization rate of E. coli at 106 CFU/ml or 108 CFU/ml in each group (P > 0.05). The scores of neovascularization in polypropylene mesh and biologic mesh were similar, which was higher than that of polytetrafluoroethylene mesh (P < 0.05). Compared with other meshes, biologic mesh showed better tolerance to 106 CFU/ml E. coli with respect to inflammation, depth of inflammation, neovascularization, cellular repopulation and foreign body giant cells.Conclusion: The biologic mesh had better E. coli resistance compared to polytetrafluoroethylene mesh and polypropylene mesh when the E. coli concentration is higher than 106 CFU/ml in rats. Antibiotic prophylaxis was useful when the contamination was not particularly severe.

Fabrication and in vitro investigation of hyperbranched poly-lysine-grafted warp knitted polypropylene sling for potential treatment of stress urinary incontinence

“…46 Xu et al pointed out that the threshold for E. coli infection in PP mesh is 10 4 CFU mL −1 . 47 To achieve effective antibacterial coating and prevent bacterial proliferation caused by the mesh, a bacterial suspension concentration higher than the critical threshold of 10 5 CFU mL −1 was chosen as the evaluation criterion. The antibacterial effects of the sling before and after modification are shown in Fig.…”

Editorial: Mesh Complications in Hernia Surgery

“…A seroma easily gets infected with the wound infection further facilitating hernia recurrence. The aggressiveness of bacteria is an important influence on the infectious load (6). Pain is caused by small nerve fibers within the wound being inflicted by microbial products such as lactic acid and by the stretching of the lax collagen beyond a fraction of a millimeter.…”

Latest Trends on the Attenuation of Systemic Foreign Body Response and Infectious Complications of Synthetic Hernia Meshes

“…44 The incidence is affected by various factors, such as mesh location and size, mesh material type and structure, and different bacterial species, concentrations, and adherence properties, and may significantly increase in high-risk situations like surgical site infection, for instance. 45,46 Infection as one kind of hernia complication is usually caused by colonization of microorganisms like bacteria, fungi, etc. ; colonization is when microorganisms fall from the environment to a body surface, settling and growing in certain areas without causing disease in the person.…”

“…The reported incidence of infection related to meshes following hernioplasty is between 1% and 8% according to different research . The incidence is affected by various factors, such as mesh location and size, mesh material type and structure, and different bacterial species, concentrations, and adherence properties, and may significantly increase in high-risk situations like surgical site infection, for instance. , …”