An off-the-shelf plasma-based material to prevent pacemaker pocket infection

Area of Science:

• Biomaterials Science
• Infectious Disease Research
• Medical Device Engineering

Background:

• Subcutaneous infections pose a significant risk for patients with cardiovascular implantable electronic devices (CIEDs).
• Preventing CIED pocket infections is crucial for patient safety and reducing healthcare costs.

Purpose of the Study:

• To evaluate the efficacy of blood plasma-based materials (PBMs) composited with antibiotics as a prophylactic agent against CIED pocket infections.
• To assess the in vitro and in vivo performance of antibiotic-eluting PBMs.

Main Methods:

• In vitro studies assessed antibiotic release, antimicrobial activity against Escherichia coli, and cytotoxicity of PBM pastes with rifampicin and minocycline.
• In vivo studies utilized a rabbit model where pacemaker pockets were inoculated with methicillin-resistant Staphylococcus aureus (S. aureus).
• PBMs with and without antibiotics were injected around pacemakers in infected pockets for comparison.

Main Results:

• In vitro studies showed sustained antibiotic release over 6 days with reduced fibroblast cytotoxicity.
• In vivo, pockets with pacemakers and S. aureus were purulent and culture-positive without PBM treatment.
• Pockets treated with antibiotic-eluting PBMs were free of purulence and culture-negative (p < 0.001), while PBMs alone showed reduced, but not eliminated, infection rates (60% culture positive).

Conclusions:

• Blood plasma-based materials (PBMs) demonstrate significant potential for delivering antibiotics to prevent pocket infections associated with pacemakers and other implantable devices.
• Antibiotic-loaded PBMs offer a promising strategy to reduce the incidence of CIED-related infections.
• Further research into PBMs could lead to improved outcomes for patients receiving implantable electronic devices.