Majumder Arnab, Scott Jeffrey R, Novitsky Yuri W
University Hospitals Case Medical Center, Cleveland, OH, USA.
Brown University, Providence, RI, USA C. R. Bard, Inc (Davol), Warwick, RI, USA.
Surg Innov. 2016 Oct;23(5):442-55. doi: 10.1177/1553350616656280. Epub 2016 Jun 28.
Background Despite meticulous aseptic technique and systemic antibiotics, bacterial colonization of mesh remains a critical issue in hernia repair. A novel minocycline/rifampin tyrosine-coated, noncrosslinked porcine acellular dermal matrix (XenMatrix AB) was developed to protect the device from microbial colonization for up to 7 days. The objective of this study was to evaluate the in vitro and in vivo antimicrobial efficacy of this device against clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli. Methods XenMatrix AB was compared with 5 existing uncoated soft tissue repair devices using in vitro methods of zone of inhibition (ZOI) and scanning electron microscopy (SEM) at 24 hours following inoculation with MRSA or E coli These devices were also evaluated at 7 days following dorsal implantation and inoculation with MRSA or E coli (60 male New Zealand white rabbits, n = 10 per group) for viable colony-forming units (CFU), abscess formation and histopathologic response, respectively. Results In vitro studies demonstrated a median ZOI of 36 mm for MRSA and 16 mm for E coli for XenMatrix AB, while all uncoated devices showed no inhibition of bacterial growth (0 mm). SEM also demonstrated no visual evidence of MRSA or E coli colonization on the surface of XenMatrix AB compared with colonization of all other uncoated devices. In vivo XenMatrix AB demonstrated complete inhibition of bacterial colonization, no abscess formation, and a reduced inflammatory response compared with uncoated devices. Conclusion We demonstrated that XenMatrix AB possesses potent in vitro and in vivo antimicrobial efficacy against clinically isolated MRSA and E coli compared with uncoated devices.
背景 尽管采用了细致的无菌技术和全身使用抗生素，但补片的细菌定植仍是疝修补术中的一个关键问题。一种新型的米诺环素/利福平酪氨酸包被的、非交联的猪脱细胞真皮基质（XenMatrix AB）被研发出来，可使该装置在长达7天的时间内免受微生物定植。本研究的目的是评估该装置对临床分离的耐甲氧西林金黄色葡萄球菌（MRSA）和大肠杆菌的体外和体内抗菌效果。方法 使用体外抑菌圈（ZOI）和扫描电子显微镜（SEM）方法，将XenMatrix AB与5种现有的未包被软组织修复装置在接种MRSA或大肠杆菌24小时后进行比较。这些装置还在背部植入并接种MRSA或大肠杆菌7天后进行评估（60只雄性新西兰白兔，每组n = 10只），分别检测活菌菌落形成单位（CFU）、脓肿形成和组织病理学反应。结果 体外研究表明，XenMatrix AB对MRSA的抑菌圈中位数为36 mm，对大肠杆菌为16 mm，而所有未包被的装置均未显示出对细菌生长的抑制作用（0 mm）。SEM也显示，与所有其他未包被的装置相比，XenMatrix AB表面没有MRSA或大肠杆菌定植的视觉证据。在体内，与未包被的装置相比，XenMatrix AB显示出对细菌定植的完全抑制、无脓肿形成以及炎症反应减轻。结论 我们证明，与未包被的装置相比，XenMatrix AB对临床分离的MRSA和大肠杆菌具有强大的体外和体内抗菌效果。
