(1645) Seraph 100 Microbind Affinity Blood Filter and Use in Group A Streptococcus Sepsis: A Case Report

Introduction: The Seraph® 100 Microbind® Affinity Blood Filter (Seraph 100) is a single-use extracorporeal broad-spectrum sorbent hemoperfusion device authorized by FDA under EUA. Indications for use include: laboratory confirmed and symptomatic COVID-19 and life-threatening disease defined as respiratory failure, septic shock and/or multiple-organ dysfunction or failure. According to recent studies, the filter has been shown to decrease morbidity, mortality, and ICU length of stay (LOS) in both adult and pediatric populations with COVID-19.

Description: The Seraph 100 filter has been shown to decrease morbidity, mortality, ICU LOS in both adult and pediatric populations but has not been assessed in management of sepsis outside the setting of COVID-19. Use of the Seraph 100 Microbind Affinity Blood Filter is only available under EUA mainly as an adjunct treatment for COVID-19. We present a case of a 26 year-old female who developed septic shock and DIC secondary to Group A Streptococcus infection. The Seraph 100 Filter was used on the 3rd day of her ICU admission. Her shock state resolved in less than 24 hours after utilizing the Seraph 100 filter. This demonstrates how the Seraph 100 filter can be a useful tool for critically ill patients with multi-organ failure secondary to causes other than COVID-19.

Discussion: Our patient is one of very few reported cases of GAS sepsis successfully treated with the Seraph 100 filter. The Seraph Filter does not affect the plasma concentration of certain antibiotics, which is crucial in a critical care setting as doses need to be closely monitored and reviewed frequently. Early intervention with the Seraph Filter in patients with bacteremia may result in clearing bloodstream infections. A 4 hour dialysis session with a 40% reduction in pathogen removal can result in a >99% pathogen elimination. Pathogens and pro-inflammatory molecules play a significant role in sepsis-induced immune dysregulation, mitochondrial damage and coagulation disorders leading to organ failure. The mechanism by which the Seraph Filter works is using heparin to bind these pathogens and inflammatory molecules through a process called hemadsorption. By decreasing the concentration of these pathogens and pro-inflammatory molecules, clinical outcomes can be improved.