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    • Towards an Accessible Hollow Fiber Infection Model - Performance of Polysulfone Hemodialyzer Compared to a Commercial Cartridge

    David Schrey, Miklas Martens,Niklas Kroemer,Christoph Pfaffendorf, Aneeq Farooq,Sebastian G. Wicha

    Journal of Global Antimicrobial Resistance（2024）

    Dept. of Clinical Pharmacy

    Cited 0|Views0
    Abstract
    BACKGROUND The Hollow Fiber Infection Model (HFIM) is established for studying pharmacodynamic (PD) effects considering pharmacokinetic (PK) profiles. The core is a cartridge with bacteria retained outside hollow fibers, which nutrients, metabolites and anti-infectives can selectively permeate. However, commercial cartridges with high-flux polysulfone (PS) fibers are expensive (up to 1000 €), limiting academic research use. Hemodialyzers for renal replacement therapy are similarly constructed and within an affordable price range (15-30 €). AIM Comparison of cost-effective renal replacement therapy PS hemodialyzer with commercial HFIM cartridges. METHODS HFIM experiments were conducted in a commercial cartridge (FiberCell Systems C2011) and a PS hemodialyzer (Fresenius Medical Care FX paed) using a clinical E. coli treated with Ceftazidim/Avibactam (CZA) or Fosfomycin (FOS). For CZA + FOS scenarios, one commercial cartridge and three hemodialyzers were connected in parallel to assure equal conditions. RESULTS Hemodialyzers proved suitable for HFIM experiments. PD results from both systems in high and low-dose scenarios were in concordance. Notably, in two regimens (CZA 0.06/0.015 g + FOS 0.125 g and CZA 0.5/0.125 g), regrowth was observed in the commercial cartridge but not in the FX paed hemodialyzer. Conversely, FOS 4 g showed regrowth in the FX paed hemodialyzer but not in the commercial cartridge. PD effects in FX paed hemodialyzers were reproducible. CONCLUSION FX paed hemodialyzers demonstrated reproducibility in PD results, with some discrepancy from commercial cartridges. More research to explore the causes for the differences is warranted.
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    Hollow Fiber Infection Model,Pharmacodynamic,Pharmacokinetic,Anti-infective,Dialyzer,Accessible
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    【要点】：本文提出了一种利用成本更低的聚砜膜血液透析器作为 hollow fiber 感染模型（HFIM）的替代方案，并与商业 cartridge 进行了比较，发现其在药效学（PD）结果上具有可重复性，且在某些情况下表现出优势。
    

    【方法】：研究通过在商业 cartridge（FiberCell Systems C2011）和聚砜膜血液透析器（Fresenius Medical Care FX paed）中开展 HFIM 实验来比较两种系统，使用了临床大肠杆菌并分别用头孢他啶/阿维巴坦（CZA）和磷霉素（FOS）进行处理。
    

    【实验】：实验中使用了 FiberCell Systems C2011 和 Fresenius Medical Care FX paed 两种设备，数据集来源于临床大肠杆菌对 Ceftazidim/Avibactam 或 Fosfomycin 的反应，以及两种药物联合使用时在两种设备中的药效学结果。实验结果显示两种系统在高剂量和低剂量场景下 PD 结果一致，但在某些特定药物组合下，两种设备显示出不同的细菌再生长情况。