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Substantiating The Link Between The Breast Implant Microbiome And Capsular Contracture Using 16S Sequencing
Tim K. Weltz, MD1, Shuang Peng, MSc, PhD
2, Andreas Larsen, MD
1, Erik E F Bak, BMSc
1, John Tran, BSc
1, Mathilde N. Hemmingsen, MD, PhD
1, Louise V. Mielke, MD
3, Jesper Trillingsgaard, MD
4, Jens J. Elberg, MD
5, Lisbet R. Hölmich, MD, DMSc
6, Lisa T. Jensen, MD
1, Peter Vester-Glowinski, MD, PhD
1, Blaine G. Fritz, MSc, PhD
2, Thomas Bjarnsholt, DMSc
2, Urvish Trivedi, BSc, PhD
2, Xuanji Li, MSc, PhD
2, Søren J. Sørensen, MSc, PhD
2, Mikkel Herly, MD, PhD
1.
1Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,
2University of Copenhagen, Copenhagen, Denmark,
3Aleris, Copenhagen, Denmark,
4AK Nygart, Copenhagen, Denmark,
5Amalieklinikken, Copenhagen, Denmark,
6Copenhagen University Hospital, Herlev-Gentofte Hospital, Herlev, Denmark.
PURPOSE: We have previously shown an association between breast implant microbiome traits and capsular contracture. However, 16S sequencing risks spurious results due to high sensitivity and needs verification on different cohorts.
METHODS: We included intact implants from patients with breast augmentation with and without capsular contracture who underwent revisional surgery. Bacteria were isolated from the entire implant surface using sonication before DNA extraction and amplicon sequencing of the hypervariable V3-V4 region of the bacterial 16S rRNA gene.
RESULTS: We included 180 implants from 122 patients in the study. The case group comprised 45 implants (25 Baker III and 20 Baker IV), and the control group comprised 78 implants (63 Baker I and 15 Baker II). After sequencing, 123 implants passed quality control and were included in the analysis. The diversity of bacteria was significantly higher in the case group compared with the controls (Shannon-Index 1.6 vs 2.0,
P=0.003), and the microbiome was significantly different in the two groups (Bray-Curtis-Distance
P≈0.001). We identified several differentially abundant bacterial genera in the two groups, including
Pelomonas and
Brevundimonas.
CONCLUSION: We verified the findings from a previous pilot study in a new cohort of patients, which substantiates the association between the breast implant microbiome and capsular contracture in the largest cohort of patients in the literature using state-of-the-art sequencing techniques.
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