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Comparison of Antibiotic-Coated versus Uncoated Porcine Dermal Matrix
Leslie E Cohen1,2, Thomas A Imahiyerobo1,2, Jeffrey R Scott1,2
1New York, N.Y.; and Providence and Warwick, R.I.
Background:
The objective of this study was to evaluate the antimicrobial performance of a rifampin/minocycline-coated, non-cross-linked, acellular porcine dermal matrix (XenMatrix AB) compared to an uncoated, non-cross-linked, acellular porcine dermal matrix (Strattice) after implantation/inoculation with methicillin-resistant Staphylococcus aureus or Escherichia coli in a dorsal rabbit model.
Methods:
Forty male New Zealand White rabbits were bilaterally implanted with XenMatrix AB or Strattice grafts and inoculated with clinically isolated methicillin-resistant S. aureus (5 × 10 colony-forming units/ml) or E. coli (1 × 10 colony-forming units/ml). At 2 and 8 weeks, sites were analyzed for viable methicillin-resistant S. aureus/E. coli colony-forming units, abscess formation, and histologic response (n = 5 rabbits per group per bacterium per time point).
Results:
XenMatrix AB completely inhibited bacterial colonization of the graft, inhibited abscess formation, reduced inflammation and encapsulation, and improved neovascularization compared with Strattice. XenMatrix AB implants exhibited significantly fewer colony-forming units compared with Strattice implants at 2 weeks (methicillin-resistant S. aureus) (p < 0.01) and at 2 and 8 weeks (E. coli) (p < 0.05). In addition, XenMatrix AB implants demonstrated a significantly lower abscess score at 2 weeks (methicillin-resistant S. aureus) and 8 weeks (E. coli) (p < 0.01 in both cases). For both types of bacteria and both time points evaluated, XenMatrix AB implants exhibited minimal inflammation and encapsulation and a lack of neutrophils. In contrast, Strattice implants displayed marked inflammatory and neutrophilic responses and moderate encapsulation.
Conclusions:
This study demonstrated the antimicrobial performance of a rifampin/minocycline-coated bioprosthetic (XenMatrix AB) in a rabbit inoculation model. XenMatrix AB completely inhibited bacterial colonization of the graft, with minimal host inflammation and encapsulation, and improved neovascularization compared with Strattice.
Insights
The rifampin/minocycline-coated XenMatrix AB completely inhibited bacterial colonization and reduced inflammation in a rabbit model. This antimicrobial bioprosthetic demonstrated superior performance compared to uncoated Strattice grafts.
Area of Science:
- Biomaterials Science
- Infectious Disease Research
- Surgical Innovation
Background:
- Acellular porcine dermal matrices are used in regenerative medicine.
- Bacterial contamination of implants is a significant clinical challenge.
- Evaluating antimicrobial coatings is crucial for improving implant safety.
Purpose of the Study:
- To assess the antimicrobial efficacy of XenMatrix AB, a rifampin/minocycline-coated matrix.
- To compare XenMatrix AB against an uncoated matrix (Strattice) in a preclinical model.
- To evaluate the host response to these matrices following bacterial challenge.
Main Methods:
- A dorsal rabbit model was used with bilateral implantation of XenMatrix AB and Strattice grafts.
- Grafts were inoculated with methicillin-resistant Staphylococcus aureus or Escherichia coli.
- Analysis included bacterial colony-forming units, abscess formation, and histology at 2 and 8 weeks.
Main Results:
- XenMatrix AB completely inhibited bacterial colonization and reduced abscess formation.
- Significantly fewer colony-forming units were observed in XenMatrix AB implants for both bacteria.
- XenMatrix AB demonstrated reduced inflammation, encapsulation, and improved neovascularization compared to Strattice.
Conclusions:
- Rifampin/minocycline coating provides potent antimicrobial activity to acellular dermal matrices.
- XenMatrix AB offers significant advantages over uncoated matrices in preventing infection and promoting healing.
- This study supports the clinical utility of antimicrobial-coated bioprosthetics.
