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Abstract: SA-PO562

Prolonged Bactericidal Activity in Extracorporeal Hemoadsorption with Vancomycin-Functionalized HA380 Sorbent Cartridge

Session Information

  • Bioengineering
    October 26, 2024 | Location: Exhibit Hall, Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Bioengineering

  • 400 Bioengineering

Authors

  • Klinkmann, Gerd, Fondazione IRRIV, Vicenza, Italy
  • Lorenzin, Anna, Fondazione IRRIV, Vicenza, Italy
  • de Cal, Massimo, Fondazione IRRIV, Vicenza, Italy
  • Toscano, Anna Italia, Fondazione IRRIV, Vicenza, Italy
  • Ramirez Guerrero, Gonzalo, Fondazione IRRIV, Vicenza, Italy
  • Reis, Thiago A., Fondazione IRRIV, Vicenza, Italy
  • Zanella, Monica, Fondazione IRRIV, Vicenza, Italy
  • Ronco, Claudio, Fondazione IRRIV, Vicenza, Italy
Background

Blood purification therapies hold promise in addressing complications linked to bacteremia, a key predictor of mortality in sepsis. However, antibiotic treatment, the current standard therapy, poses risks of organ toxicity. To alleviate this burden and expand the scope of sorbent technology, we propose using surface-modified adsorption cartridges to reduce circulating bacteria. The current study investigates the in vitro efficacy of a sorbent device (mini-module with HA380 beads, Jafron Medical, China) functionalized with vancomycin, evaluating its impact on circulating Staphylococcus aureus and compare it to standard of care antibiotic treatment in a simulated circulation model.

Methods

In an in vitro model, 1400 mL of heparinized blood containing bacterial load were split in 2 reservoirs. In Setting 1, 700 ml of blood circulated through a cartridge functionalized with vancomycin. In Setting 2, 500 mg of vancomycin were added to blood reservoir 2 and, circulated through a non-functionalized cartridge. Closed-loop hemoadsorption circuits were set up using 2 HA380 mini-modules. Circulations were maintained at 250 mL/min for 1 hour, blood reservoirs were heated to 37°C, and stirred. Samples were drawn at predefined time points, to determine time to positivity (TTP) for bacterial replication, vancomycin levels and cytokine profiles. Reservoir 2 underwent Setting 2 twice consecutively.

Results

Dynamics of TTP exhibited a similar trajectory in both settings after 60 minutes of hemoadsorption. Following an additional hour of incubation, TTP remained unchanged in Setting 1, whereas a significant decline occurred in Setting 2. Notably, the concentration of vancomycin in Reservoir 2 decreased significantly after the first cycle of hemoadsorption. Following a second dose (500 mg) of vancomycin into Reservoir 2, TTP increased significantly again. These dynamic changes were observed again after the second cycle of hemoadsorption with the non-functionalized cartridge.

Conclusion

Using antibiotic-functionalized cartridges for bacteremia may mitigate drug toxicity concerns. Delayed bacterial growth post-vancomycin cartridge passage hints at benefits. Early adjunctive use with standard therapy may aid infection resolution, pending confirmatory clinical trials.

Funding

  • Private Foundation Support