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. 2022 Dec 12;11(1):e02884-22. doi: 10.1128/spectrum.02884-22

FIG 4.

FIG 4

Mouse model of S. aureus breast implant-associated infection (BIAI). (A) Implants recovered from saline-treated mice displayed high colony forming units (CFU) of JE2 at 1 day postinfection (dpi) (mean, 3.8 × 105; SD, 5.65 × 105; SE, 1.57 × 105), which persisted at 7 dpi (mean, 5.32 × 105; SD, 1.32 × 106; SE, 4.41 × 105). However, mice were able to control JE2 infection by 14 dpi (mean, 6.57 × 101; SD, 1.47 × 102; SE, 5.57 × 101). Triple antibiotic pocket irrigant (TAPI) significantly reduced JE2 CFU on implants compared to the saline-treated control mice at 1 dpi (P value, 0.0030; mean, 2.05 × 104; SD, 5.29 × 104; SE, 1.53 × 104). However, by 7 dpi (P value, 0.2049; mean, 1.17 × 104; SD, 2.91 × 104; SE, 7.51 × 103), there was no difference in CFU recovered from TAPI or saline-treated mice. At 14 dpi (P value, >0.9999; mean, 1.82 × 103; SD, 6.89 × 103; SE, 1.78 × 103), most mice cleared JE2 regardless of treatment. (B) Tissue from saline-treated mice displayed high CFU of JE2 at 1 and 7 dpi (mean, 3.43 × 109; SD, 5.44 × 109; SE, 1.51 × 109; and mean, 3.32 × 108; SD, 8.63 × 108; SE, 2.31 × 108, respectively). However, half the mice were able to control the infection by 14 dpi (mean, 9.50 × 105; SD, 2.83 × 106; SE, 7.56 × 105). TAPI significantly reduced CFU in the tissue compared to the saline-treated mice at 1 and 7 dpi (P value, 0.0002; mean, 6.72 × 108; SD, 2.19 × 109; SE, 6.32 × 108; and P value, 0.0089; mean, 1.86 × 107; SD, 4.10 × 107; SE, 1.03 × 107, respectively). Again, about half the mice cleared the infection with JE2 regardless of treatment by 14 dpi (P value, 0.4409; mean, 1.27 × 106; SD, 5.05 × 108; SE, 1.26 × 106). (C) Implants recovered from saline-treated mice displayed high CFU of 117 at 1 dpi (mean, 2.84 × 105; SD, 5.40 × 105; SE, 1.50 × 105), which persisted at both 7 and 14 dpi (mean, 4.97 × 104; SD, 1.57 × 105; SE, 4.96 × 104; and mean, 6.31 × 104, SD, 1.03 × 105; SE, 3.64 × 104, respectively). There was no significant difference in CFU recovered from implants of TAPI-treated mice at 1 dpi (P value, 0.0640; mean, 3.87 × 104; SD, 5.81 × 104; SE, 1.61 × 104), 7 dpi (P value, 0.2481; mean, 1.01 × 105; SD, 1.85 × 105; SE, 5.34 × 104), and 14 dpi (P value, 0.0557; mean, 1.95 × 102; SD, 4.37 × 102; SE, 1.13 × 102) compared to saline-treated mice. (D) Tissue from saline-treated mice displayed high CFU of 117 at 1 dpi (mean, 8.35 × 107; SD, 1.28 × 108; SE, 3.43 × 107), which persisted at both 7 and 14 dpi (mean, 1.25 × 108; SD, 2.49 × 108; SE, 7.18 × 107; and mean, 1.80 × 106; SD, 5.31 × 106; SE, 1.33 × 106, respectively). There was no difference in CFU recovered from tissues of TAPI-treated mice at 1 dpi (P value, 0.1417; mean, 8.35 × 107; SD, 1.28 × 108; SE, 3.43 × 107), 7 dpi (P value, 0.3638; mean, 1.25 × 108; SD, 2.49 × 108; SE, 7.18 × 107), and 14 dpi (P value, 0.2980; mean, 1.80 × 106; SD, 5.31 × 107; SE, 1.33 × 107) compared to saline-treated mice. Red represents TAPI-treated mice, while black denotes saline-treated mice. Each circle represents the CFU recovered from an implant of each mouse. Each triangle denotes the CFU retrieved from tissue near the implant of each mouse. The Mann-Whitney U test was used to determine statistical significance, where ** indicates P < 0.01, and *** indicates P < 0.0005. P > 0.05 indicates no significant differences. Bar graphs represent the median and the interquartile range.