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Anand K Deva, Commentary on: Establishment and Characterization of Bacterial Infection of Breast Implants in a Murine Model, Aesthetic Surgery Journal, Volume 40, Issue 5, May 2020, Pages 529–530, https://doi.org/10.1093/asj/sjz251
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“Lots of people think, well, we're humans; we're the most intelligent and accomplished species; we're in charge. Bacteria may have a different outlook: more bacteria live and work in one linear centimeter of your lower colon than all the humans who have ever lived … Are we in charge, or are we simply hosts for bacteria?” 1
It is my pleasure to provide this commentary on the work led by Dr Myckatyn and his colleagues from Washington University.2 They have developed a murine model of breast implant infection armed with the latest methods of studying the complex relationship between bacteria, implant, and host. They are asking questions about the type, level, and timing of bacterial load and what happens at the earliest time points after a breast implant is inserted and comes into contact with bacteria. Not surprisingly, they showed that Pseudomonas aeruginosa was a strong biofilm former and able to survive and flourish especially with a loading 1-day prior to implantation and at relatively low inoculation levels.2P. aeruginosa is an especially prolific biofilm former and releases a number of highly immunogenic and pro-inflammatory proteins/lipids that can initiate host responses and, if present in adequate numbers, ultimately cause disease.3 By comparison, they struggled with trying to establish a Staphylococcus epidermidis biofilm, which mice were able to clear by day 7 post-inoculation. They correctly surmise that this may have as much to do with the strain of bacteria but also the variation in immune and pathogen clearance between species. Our early work across species, for example, showed that rabbits have a much higher propensity to clear bacterial inoculation than pigs, and this was one of the factors that led us to establish a porcine model of breast implant infection many years ago.4
