The survival of bacteria was evaluated in custom-made saline breast im
plants with integral injection ports in vitro and in 10 New Zealand Wh
ite rabbits for Staphylococcus aureus, Staphylococcus epidermidis, Pse
udomonas aeruginosa, and Serratia marcescens. Pseudomonas and Serratia
survived in vitro in saline-filled implants and multiplied 24-fold an
d 22-fold, respectively, from the initial inocula of 300 colony-formin
g units per cubic centimeter in 21 days. Serratia alone survived in sa
line implants placed on the dorsum of rabbits, proliferated 80-fold in
7 days, and tapered to 10-fold at the end of 3 weeks. Chemical analys
is revealed the presence of glucose in fluid from the implants in the
animal study (mean, 1.2 mg per deciliter; standard error of mean [SEM]
, 0.6) after 21 days and from human subjects (mean, 3.8 mg per decilit
er; SEM, 1.0) after 8 months to 10 years. Senatia incubated in human b
reast implant fluid samples proliferated 7-fold to 30-fold greater tha
n in the saline control in a nonaerated environment. We conclude that
some bacteria are able to proliferate in saline in breast implants. Fu
rthermore, their survival may be facilitated by a substance (i.e., glu
cose) that diffuses across the implant outer shell.