An off-the-shelf plasma-based material to prevent pacemaker pocket infection
An off-the-shelf plasma-based material to prevent pacemaker pocket infection
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DOI：
10.1016/j.biomaterials.2015.04.042
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发表时间：
2015-08-01
期刊：
影响因子：
14
通讯作者：
Campbell, Phil G.
中科院分区：
文献类型：
--
作者：
Schwartzman, David;Pasculle, A. William;Campbell, Phil G.
容纳心血管植入式电子设备的皮下“口袋”的细菌感染是一个重要的临床并发症。在这项研究中，研究了以血浆为基础的材料(PBM)中包裹的起搏器作为预防此类感染的用途。PBM是由混合的同种异体血浆和血小板制成的，是现成的生物材料，可以以复杂的3D形状、可挤压油灰或可注射浆料的形式制造。用利福平和米诺环素配制的PBM糊剂的体外研究表明，抗生素释放超过6天，对大肠杆菌具有活性，并减少了抗生素对成纤维细胞的细胞毒作用。这些材料还在兔模型中进行了体内评估，在该模型中，起搏器口袋接种了耐甲氧西林金黄色葡萄球菌(S.aureus)菌株，并在一周后进行了检查。装有起搏器和金黄色葡萄球菌的口袋大体化脓性和培养阳性，而在起搏器周围注射含有抗生素的PBM的口袋没有脓性和培养阴性(p<；0.001)。放置不含抗生素的PBM的口袋中没有一例出现脓肿，但60%的口袋培养阳性。这些结果表明，PBM有潜力提供抗生素，以减少起搏器和其他植入性设备的口袋感染的发生率。(C)2015爱思唯尔有限公司。保留所有权利。
Bacterial infection of subcutaneous "pockets" housing cardiovascular implantable electronic devices is a significant clinical complication. In this study, pacemakers encapsulated in a blood plasma-based material (PBM) composited with antibiotics were investigated for use as prophylactics against such infections. PBMs, which are made from pooled allogeneic plasma and platelets, are off-the-shelf biomaterials that can be manufactured in the form of complex 3D shapes, extrudable putties, or injectable pastes. In vitro studies with PBM pastes formulated with rifampicin and minocycline demonstrated antibiotic release over 6 days, activity against Escherichia coli, and reduced cytotoxic effects of the antibiotics on fibroblasts. The materials were also evaluated in vivo in a rabbit model in which pacemaker pockets were inoculated with methicillin-resistant Staphylococcus aureus (S. aureus) strain and examined 1 week later. The pockets containing the pacemaker plus S. aureus were grossly purulent and culture positive, whereas pockets into which PBM with antibiotics were injected around the pacemaker were free of purulence and culture negative (p < 0.001). None of the pockets into which PBM without antibiotics were placed demonstrated purulence, but 60% were culture positive. These results demonstrate the potential of PBMs to deliver antibiotics to diminish the incidence of pocket infections for pacemakers and other implantable devices. (C) 2015 Elsevier Ltd. All rights reserved.