title: Evaluation of the Antimicrobial Efficacy of a Novel Rifampin/Minocycline-Coated, Noncrosslinked Porcine Acellular Dermal Matrix Compared With Uncoated Scaffolds for Soft Tissue Repair.
abstract: 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.
authors.affiliation: University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Arnab
authors.initials: A
authors.lastname: Majumder
authors.affiliation: Brown University, Providence, RI, USA C. R. Bard, Inc (Davol), Warwick, RI, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Scott
authors.affiliation: University Hospitals Case Medical Center, Cleveland, OH, USA yuri.novitsky@uhhospitals.org.
authors.forename: Yuri W
authors.initials: YW
authors.lastname: Novitsky
mesh_terms: D062088:Acellular Dermis / Q000187:drug effects*; D000818:Animals; D020099:Coated Materials, Biocompatible; D004359:Drug Therapy, Combination; D006085:Graft Survival; D007150:Immunohistochemistry; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D008854:Microscopy, Electron; D008911:Minocycline / Q000494:pharmacology*; D023421:Models, Animal; D011817:Rabbits; D012016:Reference Values; D012293:Rifampin / Q000494:pharmacology*; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013234:Stem Cells; D013552:Swine
chemical_list: D020099:Coated Materials, Biocompatible; D008911:Minocycline; D012293:Rifampin
keywords: Escherichia coli; acellular dermal matrix; antibiotics; antimicrobial; bacterial colonization; mesh; methicillin-resistant Staphylococcus aureus (MRSA); minocycline; rifampin; ventral hernia repair