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Aesthet Surg J. 2019 Jul 1. pii: sjz190. doi: 10.1093/asj/sjz190. [Epub ahead of print]

Establishment and Characterization of Bacterial Infection of Breast Implants in a Murine Model.

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Washington University School of Medicine, St. Louis, MO.



Staphylococcus epidermidis and Pseudomonas aeruginosa are the most common causes of Gram-positive and -negative breast implant-associated infection. Little is known about how these bacteria infect breast implants as a function of implant surface characteristics and timing of infection.


To establish a mouse model for studying the impact of various conditions on breast implant infection.


91 mice were implanted with 273 breast implant shells and infected with S. epidermidis or P. aeruginosa. Smooth, microtextured, and macrotextured breast implant shells were implanted in each mouse. Bacterial inoculation occurred during implantation or 1 day later. Implants were retrieved 1 or 7 days later. Explanted breast implant shells were sonicated, cultured, and colony forming units determined or analyzed with scanning electron microscopy.


When implanted and infected concurrently, P. aeruginosa bacterial biofilms were below detectable limits 1 day post-implantation on all device surfaces but several logs higher than the inoculating dose 7 days later on textured breast implant surfaces. When infected 1 day after implantation, P. aeruginosa infection was robust on implant shells retrieved 1 and 7 days post-infection, particularly on the macrotextured devices. Low levels of S. epidermidis were detected on implants infected 2 days post-implantation but 1 day post-infection. S. epidermidis infection was suppressed 7 days post-infection regardless of timing of infection or implant surface.


S. epidermidis required higher inoculating doses to cause infection and was cleared within 7 days. P. aeruginosa infected at lower inoculating doses with robust biofilms noted 7 days later.


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