Microscopic detection of viable Staphylococcus epidermidis in peri-implant tissue in experimental biomaterial-associated infection, identified by bromodeoxyuridine incorporation

Infect Immun. 2010 Mar;78(3):954-62. doi: 10.1128/IAI.00849-09. Epub 2010 Jan 4.

Abstract

Infection of biomedical devices is characterized by biofilm formation and colonization of surrounding tissue by the causative pathogens. To investigate whether bacteria detected microscopically in tissue surrounding infected devices were viable, we used bromodeoxyuridine (BrdU), a nucleotide analogue that is incorporated into bacterial DNA and can be detected with antibodies. Infected human tissue was obtained postmortem from patients with intravascular devices, and mouse biopsy specimens were obtained from mice with experimental biomaterial infection. In vitro experiments showed that Staphylococcus epidermidis incorporated BrdU, as judged from staining of the bacteria with anti-BrdU antibodies. After incubation of bacteria with BrdU and subsequent staining of microscopic sections with anti-BrdU antibodies, bacteria could be clearly visualized in the tissue surrounding intravascular devices of deceased patients. With this staining technique, relapse of infection could be visualized in mice challenged with a low dose of S. epidermidis and treated with dexamethasone between 14 and 21 days after challenge to suppress immunity. This confirms and extends our previous findings that pericatheter tissue is a reservoir for bacteria in biomaterial-associated infection. The pathogenesis of the infection and temporo-spatial distribution of viable, dividing bacteria can now be studied at the microscopic level by immunolabeling with BrdU and BrdU antibodies.

MeSH terms

  • Animals
  • Bacteriological Techniques / methods*
  • Biocompatible Materials
  • Bromodeoxyuridine / metabolism*
  • Catheter-Related Infections / diagnosis*
  • Catheter-Related Infections / microbiology
  • Humans
  • Immunohistochemistry / methods
  • Mice
  • Microbial Viability*
  • Microscopy / methods
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / microbiology
  • Staining and Labeling / methods
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / microbiology
  • Staphylococcus epidermidis / growth & development
  • Staphylococcus epidermidis / isolation & purification*
  • Staphylococcus epidermidis / metabolism

Substances

  • Biocompatible Materials
  • Bromodeoxyuridine