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Biofilms associated with bowel necrosis: A newly recognised phenomenon in infants

Giulia Brisighelli, Sharon Cox, Andre Theron, Komala Pillay, Heinz Rode

Abstract


Background. A biofilm is defined as a collection of organisms attached to a surface and surrounded by a matrix.

Objective. To present three cases in which bowel necrosis coexisted with biofilm.

Methods. The medical records, bacteriological findings and tissue biopsies from three infants with bowel necrosis who subsequently died from sepsis were analysed. Tissue sent for histological evaluation was prepared for light microscopy. Haematoxylin and eosin (H&E), Sandiford and Alcian blue/periodic acid Schiff (ABPAS) stains were performed. Tissue samples were ex-waxed for electron microscopy in one case.

Results. The three patients described all had necrotic bowel at laparotomy, all cultured Klebsiella pneumoniae from peritoneal pus swabs, and all died despite appropriate antibiotics. All specimens showed varying degrees of bowel necrosis and an organising acute peritoneal reaction. In addition, all showed colonies of Gram-negative bacteria within a mucopolysaccharide matrix.

Conclusions. The identification of biofilms in necrotic bowel has raised questions regarding their clinical implications. Further studies are needed to evaluate all resected necrotic bowel for biofilms and the clinical implications of this finding. 


Authors' affiliations

Giulia Brisighelli, UOC Chirurgia Pediatrica, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

Sharon Cox, Clinical Unit, Department of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa, and Faculty of Health Sciences, University of Cape Town, South Africa

Andre Theron, Department of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

Komala Pillay, Department of Anatomical Pathology, National Health Laboratory Services, Red Cross War Memorial Children’s Hospital and University of Cape Town, South Africa

Heinz Rode, Department of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa, and Faculty of Health Sciences, University of Cape Town, South Africa

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Keywords

Biofilm, Bowel necrosis, Klebsiella pneumoniae

Cite this article

South African Medical Journal 2016;106(4):345-347. DOI:10.7196/SAMJ.2016.v106i4.10425

Article History

Date submitted: 2015-12-04
Date published: 2016-02-22

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