Antimicrobial resistance and biofilm formation of penile prosthesis isolates: insights from in-vitro analysis.

This article focuses on the biofilm-forming capacity and antibiotic resistance of bacterial isolates obtained from explanted inflatable penile prostheses (IPPs) removed for both infected and non-infected indications. The study tested 35 bacterial isolates from 11 patients against various single and combination antibiotic regimens in vitro, finding that nearly all species, except Staphylococcus warneri, formed robust biofilms and exhibited broad resistance to common perioperative antimicrobials. Notably, antibiotic resistance and biofilm formation did not differ significantly between isolates from infected versus non-infected devices, suggesting that microbial colonization and infection involve complex host–microbe interactions beyond simple presence of resistant biofilm-forming bacteria. These findings highlight the persistence of diverse, antibiotic-resistant microbial communities on IPPs despite prophylaxis and underscore the need for further research into mechanisms distinguishing colonization from infection to inform future preventive strategies.