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Hakami NY, Al-Ahdal AM, Al-Sulami AJ, Alabbadi HM, Sindi MM, Gholam KA, Bayuomi MM, Qadah T. Chemical and Microbiological Changes of Expired Platelet Concentrate. Int J Gen Med 2024; 17:1433-1439. [PMID: 38617052 PMCID: PMC11016247 DOI: 10.2147/ijgm.s449003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
Background Platelets are a commonly used blood component to prevent or treat bleeding in patients with thrombocytopenia or platelet dysfunction. They are stored at room temperature (22-24°C) for five days unless specific measures are taken to extend the shelf life to seven days or more. After five days, this study evaluated platelet units' biochemical changes and bacterial growth. Study Design and Methods Platelet concentrate was collected from 30 random donors: 8 females and 22 males. The collected samples were then placed on an agitator at room temperature and tested for their pH, protein content, and glucose levels using Roche Combur 100 Test® Strips. The Haemonetics eBDS™ System was used for bacterial detection. The measurements were taken on day five as the control and then repeated on days 7, 9, and 11 to observe any changes. On days 5 and 7, all parameters remained unchanged. However, glucose levels significantly changed (p=<0.0001) on days 9 and 11. Regarding pH, a significant change was observed on day 9 (p=0.033) and day 11 (p=0.0002). Results There were no significant changes in all parameters on days 5 and 7. However, glucose was substantially changed (p=<0.0001) on days 9 and 11. For pH, there was a significant change in pH on day 9 (p=0.033) and day 11 (p=0.0002). Discussions Our study found that platelet concentrate extension is possible for up to seven days. However, further studies are needed to evaluate platelet function during expiry time and to assess the stability of platelet morphology and function.
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Affiliation(s)
- Nora Y Hakami
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulrahman M Al-Ahdal
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Hematology Department, King Salman Bin Abdulaziz Medical City, Medinah, Saudi Arabia
| | - Afnan J Al-Sulami
- Blood Transfusion Services Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Httan M Alabbadi
- Blood Transfusion Services Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mamdouh M Sindi
- Clinical Chemistry Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Kholoud A Gholam
- Blood Transfusion Services Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Maiman M Bayuomi
- Blood Transfusion Services Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Talal Qadah
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Johnson P, Moriwaki M, Johnson J. Rapid, sensitive detection of bacteria in platelet samples with Fountain Flow Cytometry. J Clin Lab Anal 2017; 31:e22115. [PMID: 28177537 PMCID: PMC6817245 DOI: 10.1002/jcla.22115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/21/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There is a current need to develop a technique for bacterial screening of platelet donations that is more rapid, sensitive, and economical than alternatives. The objective of this research was to perform a pilot test of the viability of Fountain Flow Cytometry (FFC), for the rapid and sensitive detection of bacteria in platelet donations. METHODS Platelet samples were inoculated with serial dilutions of five selected bacterial strains. Samples were then centrifuged, reconstituted in buffer, and stained with a live/dead bacterial stain cocktail. The resulting aqueous sample was measured by FFC, in which the sample passed as a stream in front of an LED, which excited the fluorescent labels. Fluorescence was detected with a digital camera as the sample flowed toward it. RESULTS Fountain Flow Cytometry enumeration yielded results that were linear with bacterial concentration, having an R2 of ≥0.98 with a detection efficiency of 92%±3%. Measurements of uninoculated samples showed a false-positive detection rate at ~400 colony forming units (CFU)/mL. Detection of bacterial concentrations in platelets above this threshold can be made in ~15 minutes, including sample preparation time. CONCLUSION This pilot study supports the efficacy of FFC for the rapid and sensitive screening of platelet donations for bacteria.
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Affiliation(s)
- Paul Johnson
- Department of Physics and AstronomyUniversity of WyomingLaramieWYUSA
- SoftRay IncLaramieWYUSA
| | - Mika Moriwaki
- Molecular Medicine ProgramUniversity of UtahSalt Lake CityUTUSA
| | - Joseph Johnson
- College of Osteopathic Medicine of the PacificWestern University of Health SciencesPomonaCAUSA
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3
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Abstract
A wide variety of clinical conditions, associated with low circulating platelet counts, require platelet transfusion in order to normalize hemostatic function. Although single-donor apheresis platelets bear the lowest risk of transfusion-transmitted infections, pathogen reduction technologies (PRT) are being implemented worldwide to reduce this risk further through inactivation of known, emergent and as yet to be discovered nucleic acid-based pathogens. Human blood platelets are now known to harbor a diverse transcriptome, important to their function and comprised of >5000 protein-coding messenger RNAs and different classes of non-coding RNAs, including microRNAs. Our appreciation of the nucleic acid-dependent functions of platelets is likely to increase. On the other hand, the side effects of PRT on platelet function are underappreciated. Recent evidences suggest that PRT may compromise platelets' responsiveness to agonists, and induce platelet activation. For instance, platelets have the propensity to release proinflammatory microparticles (MPs) upon activation, and the possibility that PRT may enhance the production of platelet MPs in platelet concentrates (PCs) appears likely. With this in mind, it would be timely and appropriate to investigate other means to inactivate pathogens more specifically, or to modify the currently available PRT so to better preserve the platelet function and improve the safety of PCs; platelets' perspective to PRT deserves to be considered.
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Affiliation(s)
- Abdimajid Osman
- a Department of Clinical Chemistry , Region Östergötland , Linköping , Sweden.,b Department of Clinical and Experimental Medicine , University of Linköping , Linköping , Sweden
| | - Walter E Hitzler
- c Transfusion Center, University Medical Center of the Johannes Gutenberg University Mainz , Hochhaus Augustusplatz , Mainz , Germany
| | - Patrick Provost
- d CHUQ Research Center/CHUL , 2705 Blvd Laurier, Quebec , QC , Canada.,e Faculty of Medicine , Université Laval , Quebec , QC , Canada
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Razjou F, Naghadeh HT, Ferdowsi S, Dabirmoghadam A. Evaluation of the Sensitivity and Specificity of Use of Glucose and pH for Bacterial Screening of Platelet Concentrates Compared to the Bact/Alert. Indian J Hematol Blood Transfus 2017; 33:116-120. [PMID: 28194067 DOI: 10.1007/s12288-016-0660-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/10/2016] [Indexed: 11/27/2022] Open
Abstract
Bacterial contamination of blood components is the major infectious risk in transfusion medicine. Since platelets should be stored at room temperature that makes them an excellent growth medium for bacteria; it is mentioned as a major problem in transfusion medicine. Transfusion risk of a bacterial contaminated platelet concentrate is higher than viral pathogen such as HIV, HBV, HCV and HTLV. The objective of this study was to evaluation of the sensitivity and specificity of use of glucose and pH for bacterial screening of platelet concentrates compared to the Bact/Alert. 1332 platelet concentrates were screened by the Bact/Alert system for aerobic and anaerobic bacterial contamination. Bacterial contamination was also evaluated by using urine reagent strips (Multistix10 SG Bayer) and culture methods. Moreover PH screening with a pH meter (Metrohm 744 Swiss) and glucose was also used for detection of bacterial contamination. The rate of bacterial contamination detected by the Bact/Alert system in platelet concentrates was 25 in 1332 (1.9 %). It contained 15 (1.1 %) for aerobic bacteria and 10 (.8 %) for anaerobic bacteria. 226 of 1332 were considered as containing bacteria by using urine reagent strips. Six of the 226 units were also positive by the Bact/Alert system. Three of those units were culture positive for aerobic bacteria and three for anaerobic. The result of platelet concentrates that underwent pH screening by use of pH meter and a pH portion of urine reagent strips was the same. The sensitivity and specificity of considering glucose alone for detection of bacterial contamination were 12 and 98 % respectively. For pH alone, these were 24 and 83 %. For glucose and/or pH, these were 24 and 83 %; and for combination of glucose and pH, these were 12 and 98 %. Our results showed use of glucose/pH strips would improve the safety of blood products and should be encouraged.
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Affiliation(s)
- Farhad Razjou
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, IBTO, Tehran, Iran
| | - Hossein Timori Naghadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, IBTO, Tehran, Iran
| | - Shirin Ferdowsi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, IBTO, Tehran, Iran
| | - Abolfazl Dabirmoghadam
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, IBTO, Tehran, Iran
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Chatterjee K, Zaman S, Chaurasia R, Singh S, Keil SD, Tewari S, Bisht A, Agarwal N, Rout D, Chand S, Saha K. Evaluation of Mirasol pathogen reduction system by artificially contaminating platelet concentrates with Staphylococcus epidermidis: A pilot study from India. Asian J Transfus Sci 2016; 10:127-31. [PMID: 27605849 PMCID: PMC4993081 DOI: 10.4103/0973-6247.187946] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to assess the efficacy of Mirasol pathogen reduction system for platelets aimed at preventing bacterial regrowth by spiking buffy coat pooled platelets (BCPP) with clinically relevant load of Staphylococous epidermidis. MATERIALS AND METHODS BCPP units were prepared using Teruflex BP-kit with Imugard III-S-PL (Terumo BCT, Tokyo, Japan). Two BCPP units were pooled, of which 40 ml of negative control (NC) was removed. The remaining volume of the platelet unit was inoculated with clinically relevant load of bacteria (total of 30 CFU of S. epidermidis in 1 ml); following this the platelet unit was split into two parts. One part served as positive control (PC) and the other part was subjected to pathogen reduction technique (Mirasol PRT, CaridianBCT Biotechnologies, Lakewood, CO, USA). Bacterial detection was performed using BacT/ALERT system, controls after day 1 and day 7 following inoculation of bacteria and on day 7 for Mirasol-treated unit. RESULTS Of the 32 treatment cycles, 28 were valid and 4 were invalid. No regrowth was observed in 96.4% (27 of 28) after treatment with Mirasol pathogen reduction system. Of four invalid tests, on two instances the NC showed growth, whereas in other 2 no regrowth was detected in 7(th) day PC. Bacterial screening of PCs by BacT/ALERT after 24 h of incubation was 28.6%, whereas the effectiveness increased to 100% when incubated for 7 days. CONCLUSIONS Mirasol system was effective in inactivating S. epidermidis when it was deliberately inoculated into BCPP at clinically relevant concentrations. Such systems may significantly improve blood safety by inactivating traditional and emerging transfusion-transmitted pathogens.
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Affiliation(s)
- Kabita Chatterjee
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Shamsuz Zaman
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Rahul Chaurasia
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Surinder Singh
- National Institute of Biologicals, Noida, Uttar Pradesh, India
| | | | - Shalini Tewari
- National Institute of Biologicals, Noida, Uttar Pradesh, India
| | - Akanksha Bisht
- Haemovigilance Programme, National Institute of Biologicals, Noida, Uttar Pradesh, India
| | - Nitin Agarwal
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Diptiranjan Rout
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Subhash Chand
- National Institute of Biologicals, Noida, Uttar Pradesh, India
| | - Kallol Saha
- National Institute of Biologicals, Noida, Uttar Pradesh, India
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Zaki MES, Fouda M, Sharaf eldeen OA, Zaghloul MHED. Extracellular accumulation of bioactive substances; Interleukin-1β (IL-1β) and plasminogen activator inhibitor-1 (PAI-1) in stored blood units and relation to bacterial contamination. Hematology 2013; 11:301-5. [PMID: 17178672 DOI: 10.1080/10245330600702745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Bacterial contamination of blood and its cellular components remains an unresolved problem in transfusion medicine and is considered to be the most common microbiological cause of transfusion associated morbidity and mortality. The present work was designed to explore the levels of two bioactive compounds interleukin-1 beta (IL-1beta) and plasminogen activator inhibitor-1 (PAI-1) in stored blood units and their relation to bacterial contamination of these units. This study was conducted on 112 blood units obtained from blood bank of Mansoura University Children Hospital. Sequential blood samples were obtained both immediately at donation and after 10 days for measurement of IL-1beta and PAI-1 and for bacterial culture by BACTEC 9050 system. There was statistically significant increase in both IL-1 beta and PAI-1 (P = 0.0001) after 10 days of blood units storage. Bacteriological culture revealed no growth in 68% and positive growth in 32% of blood units. The commonest isolated organism was Staphylococcus aureus (15%) followed by Staphylococcus epidermedis (13%) then Yersinia sp. and Enterobacter sp. (2%) for each. From the present study we could conclude that stored blood units contain platelets and WBCs derived bioactive substances PAI-1 and IL-1beta which increase with the duration of blood storage. Furthermore, the extended duration of storage carries the danger of blood contamination by bacteria. Automated blood culture system seems to be helpful in identification of bacterial contamination of blood units. We recommend fresh blood transfusion as early as possible and the practice of Leucofiltration to avoid blood transfusion complications.
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Affiliation(s)
- Maysaa El Sayed Zaki
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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Müller TH, Montag T, Seltsam AW. Laboratory Evaluation of the Effectiveness of Pathogen Reduction Procedures for Bacteria. ACTA ACUST UNITED AC 2011; 38:242-250. [PMID: 22016694 DOI: 10.1159/000330338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 05/05/2011] [Indexed: 11/19/2022]
Abstract
SUMMARY: Bacterial contamination remains a leading factor for transfusion-associated serious morbidity and mortality. Pathogen reduction procedures offer a pro-active approach to prevent bacterial contamination of cellular blood components and especially of platelet concentrates. In the past, the laboratory evaluation of the effectiveness of the pathogen reduction procedures to minimise the bacterial load of blood components has been primarily based on log reduction assays similar to the assessment of antiviral activities. Bacteria strains with the ability to multiply in the blood components are seeded in highest possible cell numbers, the pathogen reduction procedure is applied, and the post-treatment number of bacteria is measured. The effectiveness of the procedure is characterised by calculating the log reduction of the post- to pre-treatment bacteria titres. More recently, protocols have been developed for experiments starting with a low bacteria load and monitoring the sterility of the blood component during the entire storage period of the blood component. Results for 3 different pathogen reduction technologies in these experimental models are compared and critical determinants for the results are addressed. The heterogeneity of results observed for different strains suggests that the introduction of international transfusion-relevant bacterial reference strains may facilitate the validity of findings in pathogen reduction experiments.
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Affiliation(s)
- Thomas H Müller
- DRK-Blutspendedienst NSTOB, Institut Springe, Langen, Germany
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8
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Yazer MH, Stapor D, Triulzi DJ. Use of the RQI test for bacterial screening of whole blood platelets. Am J Clin Pathol 2010; 133:564-8. [PMID: 20231609 DOI: 10.1309/ajcpyfkec90mfqcd] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
We compare our experience using a new rapid qualitative immunoassay (RQI) test (platelet Pan Genera Detection, Verax, Worcester, MA) for bacterial screening of whole blood platelet (WBP) pools with our previous WBP bacterial screen, pH testing. All WBP pools were RQI tested at the time of issue. All RQI+ pools were cultured in an automated culture system, with subsequent bacterial identification if the culture was positive. During approximately 5.5 months, 7,733 WBP pools were RQI tested. There were 14 positive RQI tests; 12 WBP pools were sterile when cultured and considered false-positive RQI tests. One pool was positive for coagulase-negative Staphylococcus, while another was positive for group B Streptococcus. The specificity and positive predictive value of the RQI test were 99.85% and 14.3%, respectively. The specificity and positive predictive value of the RQI test were higher than pH testing, leading to less waste of sterile WBP pools.
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Rieder R, Zavizion B. Monitoring the physiologic stress response: a novel biophysical approach for the rapid detection of bacteria in platelet concentrate. Transfusion 2008; 48:2596-605. [DOI: 10.1111/j.1537-2995.2008.01880.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Motoyama Y, Yamaguchi N, Matsumoto M, Kagami N, Tani Y, Satake M, Nasu M. Rapid and sensitive detection of viable bacteria in contaminated platelet concentrates using a newly developed bioimaging system. Transfusion 2008; 48:2364-9. [DOI: 10.1111/j.1537-2995.2008.01863.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Müller TH, Mohr H, Montag T. Methods for the detection of bacterial contamination in blood products. Clin Chem Lab Med 2008; 46:933-46. [PMID: 18624616 DOI: 10.1515/cclm.2008.154] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Culture-based and molecular assays have been developed for the screening of platelet concentrates and other blood components for bacterial contaminations. In this review, the principles of the assays are outlined. The focus of this review is the assessment of the analytical qualities of the methods. Spiking studies by adding defined levels of a wide range of bacteria to the complex biological matrix provide the first basis to evaluate and compare the qualities of methods for bacterial detection. The sensitivity acceptable for reliable screening for bacteria critically depends on the timing of either early sampling (within a period of up to 24 h after preparation of the blood component) or late sampling (a few hours before issuing the blood component). Large screening studies are essential to confirm both adequate sensitivity and specificity of the testing. In the ideal setting, these studies are prospectively planned and include systematic surveillance of adverse events in response to the administration of the screened products. The findings from sterility testing (predominantly with automated systems for detection of bacteria based on CO(2) generation) of more than 550,000 platelet concentrates in 13 studies are summarised. The limitations of the early sampling and the "negative-to-date" strategy to issue platelet concentrates are addressed. A few reported cases of probable transmission of bacteria by platelet transfusion despite negative screening tests emphasise the need to further develop optimised methods for testing of bacteria blood components.
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Affiliation(s)
- Thomas H Müller
- Institute Springe, German Red Cross-Blood Transfusion Service NSTOB, Springe, Germany.
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Störmer M, Kleesiek K, Dreier J. pH value promotes growth of Staphylococcus epidermidis in platelet concentrates. Transfusion 2008; 48:836-46. [PMID: 18298602 DOI: 10.1111/j.1537-2995.2008.01644.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The platelet (PLT) storage lesion is characterized metabolically by a pH value associated with lactic acid generation. PLT storage conditions support the growth of Staphylococcus epidermidis, the most common organism implicated in bacterial contamination of PLT concentrates (PCs). Here, different factors that influence bacterial growth in PCs are discussed and the relation between pH values of PCs and citrate plasma (CP) is studied, with emphasis on bacterial proliferation. STUDY DESIGN AND METHODS The PLT lesion with regard to pH decrease and lactic acid production was monitored during storage and correlated to bacterial proliferation properties. A total of 115 coagulase-negative staphylococci, especially S. epidermidis isolates, were characterized for their proliferation in different blood components (CP, buffy coat-derived, and apheresis PCs). Furthermore, the influence of donor-specific, product-specific, species-specific, and strain-specific factors on bacterial proliferation was investigated. RESULTS PCs showed a lower pH value in comparison to plasma during storage. Bacterial proliferation in PCs and the failure to grow in CP were determined with all organisms tested. No correlation to donor-specific, species-specific, or strain-specific factors was observed. Lowering the pH of CP resulted in bacterial proliferation, whereas a pH increase in the PC unit inhibited the proliferation of S. epidermidis. CONCLUSION With emphasis on bacterial proliferation, the significant difference between PC and CP is the presence of metabolizing PLTs. The pH values of stored PLTs, but not those of stored plasma, support the growth of S. epidermidis.
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Affiliation(s)
- Melanie Störmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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Abstract
Since the impressive reduction of transfusion-transmitted virus infections, bacterial infections by blood transfusion represent the most important infection risk. Platelet concentrates are the current focus of attention, as they are stored under temperature conditions which allow growth of contaminating bacteria up to 10(10) and more microbes per platelet bag. This paper does not consider the pathogen reduction methods but will assess suitable screening methods. Beside conventional microbiological approaches or surrogate markers, several efficient methods able to detect bacterial contamination in platelets are available on the market. They need to be divided into two different methodological principles: the cultivation methods and rapid methods. Cultivation or incubation methods require some time for signal production as they depend on growth of microbes. Thus, they have to be combined with early sampling, i.e., the sample to be examined has to be drawn from the blood component 1 day after donation. Their advantage is the relatively uncomplicated implementation into the logistics of blood banks. Because of the initially very low count of bacteria after donation, a certain small sampling error in application of that strategy remains. Rapid methods are able to produce the diagnosis within a short time. Therefore, they allow postponing of sample drawing, ideally up to the time immediately before transfusion. However, this procedure causes logistic complications. On the other hand, late sampling combined with a rapid method will prevent the transfusion of highly contaminated platelet concentrates leading to acute septic shock up to the death of the patient. Considering the sum of different aspects including the supply of patients, the potential improvement of microbial safety of platelet concentrates is comparable in both strategies.
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Affiliation(s)
- Thomas Montag
- Paul Ehrlich Institute, Section Microbial Safety, Langen, Germany.
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14
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Reesink HW, Mohammadi T, Pietersz RN, Savelkoul PH. Rapid screening by real-time 16S rDNA PCR for bacterial contamination of blood products. Clin Chem Lab Med 2008; 46:954-62. [DOI: 10.1515/cclm.2008.155] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Dreier J, Störmer M, Kleesiek K. Real-Time Polymerase Chain Reaction in Transfusion Medicine: Applications for Detection of Bacterial Contamination in Blood Products. Transfus Med Rev 2007; 21:237-54. [PMID: 17572262 DOI: 10.1016/j.tmrv.2007.03.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Bacterial contamination of blood components, particularly of platelet concentrates (PCs), represents the greatest infectious risk in blood transfusion. Although the incidence of platelet bacterial contamination is approximately 1 per 2,000 U, the urgent need for a method for the routine screening of PCs to improve safety for patients had not been considered for a long time. Besides the culturing systems, which will remain the criterion standard, rapid methods for sterility screening will play a more important role in transfusion medicine in the future. In particular, nucleic acid amplification techniques (NATs) are powerful potential tools for bacterial screening assays. The combination of excellent sensitivity and specificity, reduced contamination risk, ease of performance, and speed has made real-time polymerase chain reaction (PCR) technology an appealing alternative to conventional culture-based testing methods. When using real-time PCR for the detection of bacterial contamination, several points have to be considered. The main focus is the choice of the target gene; the assay format; the nucleic acid extraction method, depending on the sample type; and the evaluation of an ideal sampling strategy. However, several factors such as the availability of bacterial-derived nucleic acid amplification reagents, the impracticability, and the cost have limited the use of NATs until now. Attempts to reduce the presence of contaminating nucleic acids from reagents in real-time PCR have been described, but none of these approaches have proven to be very effective or to lower the sensitivity of the assay. Recently, a number of broad-range NAT assays targeting the 16S ribosomal DNA or 23S ribosomal RNA for the detection of bacteria based on real-time technology have been reported. This review will give a short survey of current approaches to and the limitations of the application of real-time PCR for bacterial detection in blood components, with emphasis on the bacterial contamination of PCs.
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Affiliation(s)
- Jens Dreier
- Institut für Laboratoriums und Transfusionsmedizin, Herz und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
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Mohammadi T, Savelkoul PHM, Pietersz RNI, Reesink HW. Applications of real-time PCR in the screening of platelet concentrates for bacterial contamination. Expert Rev Mol Diagn 2007; 6:865-72. [PMID: 17140373 DOI: 10.1586/14737159.6.6.865] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although there have been major improvements over the past few decades in detection methods for blood-borne infectious agents, platelet concentrates are still responsible for most cases of transfusion-transmitted bacterial infections. To date, real-time PCR is an indispensable tool in diagnostic laboratories to detect pathogens in a variety of biological samples. In this article, the applications of this powerful technique in the screening of platelet concentrates for bacterial contamination are discussed. Next to pathogen-specific (real-time) PCR assays, particular attention is directed to the recently developed 16S rDNA real-time PCR. This assay has been proven as a convenient way to detect bacterial contamination of platelet concentrates. The assay is sensitive and enables rapid detection of low initial numbers of bacteria in platelet concentrates. The short turnaround time of this assay allows high-throughput screening and reduction of the risk of transfusion of bacterially contaminated units. As with every method, real-time PCR has its advantages and disadvantages. These and especially limitations inherent to generation of false-positive or -negative results are emphasized. The universal nature of detection of the assay may be suitable for generalized bacterial screening of other blood components, such as red blood cells and plasma. Therefore, it is necessary to adapt and optimize detection in red blood cells and plasma with real-time PCR. Further sophistication, miniaturization and standardization of extraction and amplification methods should improve the total performance and robustness of the assay. Hence, real-time PCR is an attractive method in development as a more rapid screening test than currently used culture methods to detect bacterial contamination in blood components.
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Affiliation(s)
- Tamimount Mohammadi
- Sanquin Blood Bank North West Region, Amsterdam, The Netherlands and Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, The Netherlands.
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17
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McDonald CP. Bacterial risk reduction by improved donor arm disinfection, diversion and bacterial screening. Transfus Med 2007; 16:381-96. [PMID: 17163869 DOI: 10.1111/j.1365-3148.2006.00697.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Interventions of improved donor arm disinfection, diversion and bacterial screening have been implemented by blood services and shown to have substantial benefit. The major source of bacterial contamination is donor arm derived. Blood services are now introducing best practice donor arm disinfection techniques. Diversion has been shown to substantially reduce bacterial contamination in the order of 40-88%. Diversion, together with improved donor arm disinfection, has shown to improve the percentage of reduction in contamination from 47% to 77%. Residual contamination levels after the Introduction of diversion and improved donor arm disinfection may be in the order of 30-40%. Numerous countries have now implemented screen testing programmes for platelet concentrates, which are the major source of bacterial transfusion transmission. Pathogen reduction systems have been developed and are under development. At present, concerns remain with these systems regarding cost, process control, ability to inactivate high titres of viruses, killing of bacterial spores, product damage, genotoxicity and mutagenicity. The interventions of diversion, improved donor arm disinfection and bacterial screen testing are currently available, As such they can be implemented now to increase blood safety with no associated patient risk.
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Affiliation(s)
- C P McDonald
- National Bacteriology Laboratory, National Blood Service, Colindale, London, UK.
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Morales MD, Serra B, Guzmán-Vázquez de Prada A, Reviejo AJ, Pingarrón JM. An electrochemical method for simultaneous detection and identification of Escherichia coli, Staphylococcus aureus and Salmonella choleraesuis using a glucose oxidase-peroxidase composite biosensor. Analyst 2007; 132:572-8. [PMID: 17525815 DOI: 10.1039/b618159g] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Quantification of bacterial pollution by amperometric detection at 0.0 V of glucose consumption at a graphite-Teflon-glucose oxidase-peroxidase-ferrocene composite biosensor under flow injection conditions is reported. Using Escherichia coli as the model bacterium, the composition of the growing medium was optimized. A constant glucose concentration of 4.0 x 10(-4) M was added to the culture medium. The relative response to glucose, expressed as the ratio between the amperometric signal and the signal at incubation time t = 0 multiplied by 100, as a function of E. coli concentration, showed a typical behaviour. Limits of detection of 6.5 x 10(2) or 6.5 cfu mL(-1) were achieved after 3 or 7 h of incubation, respectively, with no pre-concentration step. The detection of bacteria did not affect the lifetime of the biosensor. The feasibility of the detection of Staphylococcus aureus and Salmonella choleraesuis throughout the glucose consumption measurement at the composite biosensor is also demonstrated. The capability of bacterial identification by evaluation of bacterial growth in the culture medium containing the antibiotics polymyxin B, vancomycin, erythromycin, bacitracin, chloramphenicol, tetracycline and ciprofloxacin, was investigated. Each micro-organism tested exhibited a different antibiotic susceptibility profile, thus suggesting the possibility of bacteria differentiation. A rapid methodology for screening of bacteria is proposed.
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Affiliation(s)
- María Dolores Morales
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, 28030 Madrid, Spain
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Schmidt M, Hourfar MK, Heck J, Weis C, Montag T, Nicol SB, Seifried E. Scansystem™ Enables Rapid and Sensitive Bacterial Detection in Platelets Stored in Additive Solution with Implementation of Standard Positive Control Capsules*. Transfus Med Hemother 2006. [DOI: 10.1159/000090111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schmidt M, Hourfar MK, Wahl A, Nicol SB, Montag T, Roth WK, Seifried E. Fluorescence quencher improves scansystemtm for rapid bacterial detection. Vox Sang 2006; 90:276-8. [PMID: 16635069 DOI: 10.1111/j.1423-0410.2006.00763.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES The optimized scansystem could detect contaminated platelet products within 24 h. However, the system's sensitivity was reduced by a high fluorescence background even in sterile samples, which led to the necessity of a well-trained staff for confirmation of microscope results. MATERIALS AND METHODS A new protocol of the optimized scansystem with the addition of a fluorescence quencher was evaluated. Pool platelet concentrates contaminated with five transfusion-relevant bacterial strains were tested in a blind study. RESULTS In conjunction with new analysis software, the new quenching dye was able to reduce significantly unspecific background fluorescence. Sensitivity was best for Bacillus cereus and Escherichia coli (3 CFU/ml). DISCUSSION The application of a fluorescence quencher enables automated discrimination of positive and negative test results in 60% of all analysed samples.
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Affiliation(s)
- M Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross, Johann Wolfgang Goethe University, Frankfurt, Germany.
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Mohr H, Lambrecht B, Bayer A, Spengler HP, Nicol SB, Montag T, Müller TH. Sterility testing of platelet concentrates prepared from deliberately infected blood donations. Transfusion 2006; 46:486-91. [PMID: 16533294 DOI: 10.1111/j.1537-2995.2006.00747.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In general the bacterial count in freshly donated blood is low and even lower in the corresponding platelet concentrates (PCs). By use of flow cytometry (FACS) for sterility testing, the reliability of early versus later sampling times was evaluated. STUDY DESIGN AND METHODS Blood donations were spiked with various numbers of Staphylococcus epidermidis, Staphylococcus aureus, Bacillus cereus, and Klebsiella pneumoniae. The corresponding PCs were prepared by the buffy-coat method and stored at 22 degrees C. A 20-mL sample was collected from each PC directly after preparation and after 8 hours. Samples were stored at 35 degrees C. Sterility testing of both PCs and samples was by FACS analysis at different time points. RESULTS All stored PCs were found positive by FACS analysis, with detection times ranging between 8 and 24 hours (K. pneumoniae, B. cereus), 8 and 91 hours (S. aureus), and 144 hours (S. epidermidis). In the samples incubated at 35 degrees C, bacteria were detected after 8 to 19 hours (K. pneumoniae, B. cereus), 8 to 67 hours (S. aureus), and 19 to 43 hours (S. epidermidis). Some of the samples did not contain bacteria. CONCLUSION Detection times for slow-growing bacteria are significantly shortened when PC samples are incubated at 35 degrees C: the numbers of bacteria in freshly prepared PCs may, however, be so low that the samples drawn for sterility testing do not contain a single bacterium. Our results do not support a shortening of the 24-hour or greater sampling time recommended by the manufacturers of established test systems, because also for consistent detection by FACS, bacteria need to grow in the PCs to sufficient numbers.
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Affiliation(s)
- Harald Mohr
- Blood Center of the German Red Cross Chapters of NSTOB, Institutes Springe and Gera, Springe and Gera, Germany.
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Müller TH, Mohr H, Montag T. Methods for the detection of bacterial contamination in blood products Screeningverfahren zum Nachweis bakterieller Kontaminationen in Blutprodukten. ACTA ACUST UNITED AC 2006. [DOI: 10.1515/jlm.2006.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mothershed EA, Whitney AM. Nucleic acid-based methods for the detection of bacterial pathogens: Present and future considerations for the clinical laboratory. Clin Chim Acta 2006; 363:206-20. [PMID: 16139259 DOI: 10.1016/j.cccn.2005.05.050] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2005] [Revised: 05/25/2005] [Accepted: 05/26/2005] [Indexed: 11/22/2022]
Abstract
BACKGROUND Recent advances in nucleic acid-based methods to detect bacteria offer increased sensitivity and specificity over traditional microbiological techniques. The potential benefit of nucleic acid-based testing to the clinical laboratory is reduced time to diagnosis, high throughput, and accurate and reliable results. METHODS Several PCR and hybridization tests are commercially available for specific organism detection. Furthermore, hundreds of nucleic acid-based bacterial detection tests have been published in the literature and could be adapted for use in the clinical setting. Contamination potential, lack of standardization or validation for some assays, complex interpretation of results, and increased cost are possible limitations of these tests, however, and must be carefully considered before implementing them in the clinical laboratory. CONCLUSIONS A major area of advancement in nucleic acid-based assay development has been for specific and broad-range detection of bacterial pathogens.
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Affiliation(s)
- Elizabeth A Mothershed
- Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Mohr H, Lambrecht B, Bayer A, Spengler HP, Nicol SB, Montag T, Müller TH. Basics of flow cytometry?based sterility testing of platelet concentrates. Transfusion 2006; 46:41-9. [PMID: 16398729 DOI: 10.1111/j.1537-2995.2005.00668.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Flow cytometry (FACS) is a common technique in blood banking. It is used, for example, for the enumeration of residual white blood cells in plasma and in cellular blood products. It was investigated whether it can also be applied for sterility testing of buffy coat-derived platelet concentrates (PCs). STUDY DESIGN AND METHODS Plasma-reduced PCs were spiked with bacteria and stored at 20 to 24 or 37 degrees C for various times. The following 10 species were used: Bacillus cereus, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Propionibacterium acnes, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Serratia marcescens, and Yersinia enterocolitica. Bacterial DNA was stained with thiazole orange. After the platelets were lysed, bacteria were enumerated by FACS. RESULTS All bacteria species used were detectable by FACS. The lower detection limit was approximately 100 bacteria per microL, that is, 10(5) per mL. In general, the titers measured were 1.2- to 3-fold higher than those determined by colony forming assay. In one case (K. pneumoniae) in which the dot plot of the bacteria cloud overlapped with that of bacteria debris, they were consistently lower. When PC samples were inoculated with approximately 1 colony-forming unit per mL of bacteria and kept at 37 degrees C, most species were detected within 21 hours or less. Exceptions were E. cloacae and P. acnes, which were detected after 24 to 40 and 64 hours, respectively. At 20 to 24 degrees C, the detection times were strongly prolonged. CONCLUSION Sterility testing of PCs by FACS is a feasible approach. The present data suggest incubating PC samples for 20 to 24 hours at 37 degrees C before testing. For slow-growing bacteria, the incubation period must be prolonged by 1 to 2 days.
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Affiliation(s)
- Harald Mohr
- Blood Center of the German Red Cross Chapters of NSTOB, Institutes Springe and Gera, Springe and Gera, Germany.
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Schmidt M, Weis C, Heck J, Montag T, Nicol SB, Hourfar MK, Schaefer V, Sireis W, Roth WK, Seifried E. Optimized Scansystemtm platelet kit for bacterial detection with enhanced sensitivity: detection within 24 h after spiking. Vox Sang 2005; 89:135-9. [PMID: 16146505 DOI: 10.1111/j.1423-0410.2005.00673.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The prevention and detection of bacterial contamination of platelet concentrates remains a major challenge for transfusion medicine. To be suitable for blood-transfusion services, the contamination detection method must be highly sensitive, easy to perform and preferably of low cost. In this spiking study, we evaluated the new optimized Scansystem Platelet Kit detection method for use on apheresis platelets. STUDY DESIGN AND METHODS Apheresis platelet concentrates (APCs) were individually spiked with 10 colony-forming units (CFU)/ml of one of 10 different strains of bacteria. The spiked APCs were analysed at specific time-points during incubation by using the optimized Scansystem Platelet Kit. Bacterial enumeration was performed by plating onto blood agar. RESULTS All the bacterial strains tested were detected by using the optimized Scansystem Platelet Kit when sampled 24 h after spiking. Compared to the Scansystem standard kit, sensitivity was increased to < 50 CFU/ml. The identity of the spiked bacteria was confirmed by Gram staining and DNA fingerprinting. CONCLUSION The optimized Scansystem Platelet Kit was able to reliably detect, within 70 min, 10 transfusion-relevant bacterial species in APCs when a sample volume was taken 24 h after spiking. This is the first study carried out by using the optimized Scansystem bacterial detection that was found to have an enhanced sensitivity compared to the standard kit.
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Affiliation(s)
- Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross, Johann Wolfgang Goethe University, Frankfurt, Germany.
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Abstract
BACKGROUND Bacterial contamination of blood products is a leading cause of transfusion-related morbidity and mortality. Transfusion services are now compelled to employ methods of detecting bacteria in platelet (PLT) components. The use of pH screening of whole-blood PLTs (WBPs) was evaluated with a pH meter at the time of issue as a surrogate test for bacterial contamination. STUDY DESIGN AND METHODS All WBPs selected for transfusion in May through September 2004 were tested individually for pH at time of issue. Those with a pH value of less than 7.0 were cultured in an automated culture system for 5 days. The white blood cell (WBC) and PLT counts in 56 representative WBP units that failed pH screening were compared to WBP units with acceptable pH values. RESULTS Of the 37,060 WBP units that underwent pH screening, 405 had a pH value of less than 7.0 (1.1%). Four of those units were culture positive (1.0%) for Staphylococcus aureus, Bacillus subtilis, diphtheroids, and coagulase-negative Staphylococcus. Only one cocomponent red blood cell (RBC) unit was culture-positive and grew the same bacteria (S. aureus) as the WBP unit. The rate of pH failure increased with WBP storage length with the greatest rate of pH failures occurring in 5-day-old WBPs. The units that failed pH screening had significantly more WBCs and PLTs than units with acceptable pH values. CONCLUSION pH screening of WBPs at issue prevented transfusion of bacterially contaminated WBPs and RBCs. This method, however, results in significant PLT wastage. Higher WBC and PLT content likely explains pH failures not due to bacterial contamination.
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Affiliation(s)
- Mark H Yazer
- Institute for Transfusion Medicine and Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Ribault S, Faucon A, Grave L, Nannini P, Faure IB. Detection of bacteria in red blood cell concentrates by the Scansystem method. J Clin Microbiol 2005; 43:2251-5. [PMID: 15872251 PMCID: PMC1153802 DOI: 10.1128/jcm.43.5.2251-2255.2005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Bacterial contamination remains one of the major risks associated with blood product transfusion. The kinetics of bacterial growth in red blood cell concentrates (RBCC) is different than otherwise due to storage at 4 degrees C, conditions in which most bacteria do not survive. Psychrophilic bacteria such as Yersinia enterocolitica, however, can proliferate from a very low level of contamination to clinically significant levels at 4 degrees C and are known to cause severe transfusion-related infections. A screening method allowing the early detection of very low levels of bacteria in RBCC would improve transfusion safety. The Scansystem method has been previously described for detection of bacteria in platelet concentrates. We present here a modification of the system for detection of low levels of bacteria in RBCC. The Scansystem RBC kit protocol requires three steps, i.e., the agglutination and selective removal of RBCs, a labeling stage during which bacteria are labeled with a DNA-specific fluorophore, and finally recovery of bacteria on the surface of a black membrane for analysis using the Scansystem. The entire procedure from sampling to result can be completed in 90 min. Both gram-negative and gram-positive bacteria in RBCC are detected with a higher sensitivity than with currently available culture-based methods. The Scansystem RBC kit is shown to be sensitive enough to identify low-level bacterial contamination in a single unit tested in a pool of up to 20 RBCC samples (detection limit of between 1 and 10 CFU/ml depending on the bacterial strain). The method therefore lends itself to incorporation into high-sample-throughput screening programs.
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Affiliation(s)
- S Ribault
- Hemosystem, 45 cours Gouffé, 13006 Marseille, France.
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McDonald CP, Colvin J, Robbins S, Barbara JAJ. Use of a solid-phase fluorescent cytometric technique for the detection of bacteria in platelet concentrates. Transfus Med 2005; 15:175-83. [PMID: 15943702 DOI: 10.1111/j.1365-3148.2005.00569.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Blood services worldwide are now striving to reduce the risk of transmission of bacteria by transfusion. The BacT/ALERT microbial detection system (bioMerieux, Basingstoke, Hants, UK) is currently regarded as the 'gold standard' for bacterial screening of platelet concentrates. The BacT/ALERT is a culture system and will not generate an 'instant' (within 2 h) determination. We report on the Scansystem (Hemosystem, Marseille, France), a solid-phase fluorescent cytometric technique, which enables the rapid detection of bacteria (within 90 min) in platelet concentrates. The study was performed in two parts - one involving the routine screening of platelet concentrates and the other determining the sensitivity of the system. In both arms of the study, the BacT/ALERT was used for comparative purposes. In total, 900 platelet concentrates were screened (63 apheresis and 837 buffy coat pooled). No bacteria were detected in any of the platelet concentrates tested by means of either the Scansystem or the BacT/ALERT. The sensitivity of the Scansystem was in the order of 10(3) cfu mL(-1). Escherichia coli and Staphylococcus aureus were detected by using the Scansystem at 1 cfu mL(-1). The BacT/ALERT detected all organisms tested (n = 6) at 1 cfu mL(-1). The Scansystem offers a sensitive alternative technology to bacterial culture, with the benefit of a rapid test time.
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Affiliation(s)
- C P McDonald
- National Blood Service, North London, London, UK.
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Morel P, Deschaseaux M, Naegelen C, Bardiaux L, des Floris MFL, Pouthier F. De la détection bactérienne à l'inactivation des pathogènes. Transfus Clin Biol 2005; 12:142-9. [PMID: 15894506 DOI: 10.1016/j.tracli.2005.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Bacterial contamination of blood components remains the highest infectious risk in blood transfusion, the risk is particularly high when it affects platelet concentrates (PC). In France, the residual risk of transfusion reaction due to bacterial contamination of PC has been decreasing slowly since 1994 but for all severity 1 case occurs with about 25,000 distributed PC and one death occurs with 200,000 distributed units. This reduction of the risk may be due to the measures which were implemented during the last 10 years in order to prevent contamination during donation. Improving strategies for reducing the risks of bacterial contamination is one of the priorities of the French National Blood Transfusion Service (l'Etablissement Français du sang - EFS). The main target remains PC. Bacterial detection or pathogens inactivation are now available and are able to reduce (for detection) or prevent (for inactivation) the occurrence of reaction due to bacterial contamination of PC. Up to now, the choice is in favour of bacterial detection. A national study was carried out in seven regional EFS at the end of 2004. It aims at confirming the feasibility of a systematic bacterial screening of PC before their delivery. The first conclusions show that this screening can be implemented with acceptable modifications in term of platelets availability. We can expect in a next future that new pathogens reduction technique and/or new detection systems will be available, certainly more efficient to prevent reaction due to bacterial contamination. Implementation of actual detection methods is probably a temporary solution.
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Affiliation(s)
- P Morel
- Etablissement français du sang Bourgogne-Franche-Comté, Besançon, France.
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Abstract
Bacterial contamination of blood components represents today the highest infectious risk in blood transfusion, the risk is particularly high when it affects platelet concentrates. The prevention methods developed over the past ten years (donor selection, phlebotomy site preparation, first 30 ml diversion, systematic leuko-reduction...) which aimed at limiting the introduction of bacteria in donations and bacterial proliferation, has reduced the risk of transfusion reaction due to the bacterial contamination. Improving strategies for reducing the risks of bacterial contamination is one of the priorities of the French National Blood Transfusion Service (l'Etablissement français du sang - EFS). It is essential to improve existent prevention methods and develop the implication of all the actors (from donation to transfusion) involved in the prevention of this risk. Bacterial detection or pathogens inactivation are now available and are able to reduce (for detection) or prevent (for inactivation) the occurrence of reaction due to bacterial contamination of PC. Up to now, the choice is in favour of bacterial detection. Three methods (BacT/Alert, BioMerieux; eBDS, Pall; ScanSystem, Hemosystem) of detection of bacterial contamination in PC can be generalised now. Adaptations, need for their implementation are acceptable, especially concerning PC availability.
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Affiliation(s)
- P Morel
- Etablissement français du Sang-Bourgogne-Franche-Comté, Besançon, France.
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Jacobs MR, Bajaksouzian S, Windau A, Palavecino EL, Yomtovian R. Evaluation of the Scansystem method for detection of bacterially contaminated platelets. Transfusion 2005; 45:265-9. [PMID: 15660837 DOI: 10.1111/j.1537-2995.2004.04252.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Platelet (PLT) bacterial contamination occurs in approximately 1 in 2000 PLT units. The College of American Pathologists recommends and AABB requires procedures to detect PLT bacterial contamination. Although two methods, BacT/ALERT (bioMerieux) and Pall BDS (Pall Corporation), have FDA approval for quality control testing, additional methods are in development. One such method was evaluated, the Scansystem (Hemosystem), which has been developed for use on leukoreduced PLT components between 30 and 72 hours after collection. STUDY DESIGN AND METHODS Leukoreduced, single-donor apheresis PLT units (LR-SDPs) were inoculated with 10 bacterial species (low and high inocula) associated with PLT contamination. Bacterial detection was compared with the Scansystem and BacT/ALERT. Testing was initiated (10 replicates performed) when LR-SDPs were experimentally inoculated with bacteria. The Scansystem was evaluated 30 hours later, the shortest manufacturer recommended time after PLT collection. RESULTS All replicates were positive with the Scansystem at 30 hours and with the BacT/ALERT, at 9.3 to 24.0 hours after inoculation. The Scansystem detected bacteria in 83 of 200 replicates (42%) at the time of inoculation indicating a potential for earlier application. CONCLUSIONS The Scansystem, used to test LR-SDPs 30 hours after bacterial inoculation, detected all 20 replicates with a sensitivity equal to the BacT/ALERT system. Based on use of Scansystem with LR-SDPs 30 hours after collection and the BacT/ALERT being inoculated 24 hours after collection and incubated for an additional 24 hours before being determined to be negative, the Scansystem will potentially provide results at an earlier time point (32 hr) than provided by the BacT/ALERT system (48 hr).
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Affiliation(s)
- Michael R Jacobs
- University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio 44106, USA
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