Monitoring the physiologic stress response: a novel biophysical approach for the rapid detection of bacteria in platelet concentrate

Single-cell level methods for studying the effect of antibiotics on bacteria during infection

Considerable evidence about phenotypic heterogeneity among bacteria during infection has accumulated during recent years. This heterogeneity has to be considered if the mechanisms of infection and antibiotic action are to be understood, so we need to implement existing and find novel methods to monitor the effects of antibiotics on bacteria at the single-cell level. This review provides an overview of methods by which this aim can be achieved. Fluorescence label-based methods and Raman scattering as a label-free approach are discussed in particular detail. Other label-free methods that can provide single-cell level information, such as impedance spectroscopy and surface plasmon resonance, are briefly summarized. The advantages and disadvantages of these different methods are discussed in light of a challenging in vivo environment.

Dielectrophoresis: applications and future outlook in point of care

Dielectrophoresis (DEP) is a label free, noninvasive, stand alone, rapid, and sensitive particle manipulation and characterization technique. Improvements in micro-electro-mechanical systems technology have enabled the biomedical applications of DEP over the past decades. By this way, integration of DEP into lab-on-a-chip systems has become achievable, creating a potential tool for point-of-care (POC) systems. DEP can be utilized in many different POC applications including early detection and prognosis of various cancer types, diagnosis of infectious diseases, blood cell analysis, and stem cell therapy. However, there are still some challenges to be resolved to have DEP-based devices available in POC market. Today, researchers have focused on these challenges to have this powerful theory as a solution for many POC applications. Here, DEP theory, cell modeling, and most common device structures are introduced briefly. Next, POC applications of DEP theory, such as cell (blood, cancer, stem, and fetal) and microorganism separation, manipulation, and enrichment for diagnosis and prognosis, are explained. Integration of DEP with other detection techniques to have more sensitive systems is summarized. Finally, future outlook for DEP-based systems are discussed with some challenges, which are currently preventing these systems to be a common tool for POC applications, and possible solutions.

Direct detection of the bacterial stress response in intact samples of platelets by differential impedance

BACKGROUND

We have previously described a new rapid approach that relies on monitoring intentionally stressed bacteria in contaminated platelet concentrates (PCs). This earlier work included human cell lysis with Triton X-100 and filtration as steps in the sample preparation. This study was undertaken to develop an improved and time-saving protocol that enables direct bacterial detection in PCs without lysis and filtration.

STUDY DESIGN AND METHODS

Apheresis- or whole blood-derived PCs were spiked with 17 model bacteria and tested at final concentrations from 10(3) to 10(6) colony-forming units (CFUs)/mL. The contaminated PCs were treated with a chemical compound that induces a stress response in bacteria and monitored using differential impedance sensing to detect and record subtle changes in the dielectric permittivities of the contaminated platelet (PLT) samples.

RESULTS

No measurable responses from sterile PLT samples were observed during exposure to the compounds used as stressors. In contrast, distinct response profiles were obtained without exception for all 17 bacterial species for all bacterial concentrations tested. Bacterial presence was established within 5 to 10 minutes for high inocula (10(6) and 10(5) CFUs/mL) while low inocula (10(4) and 10(3) CFUs/mL) were usually detectable within 20 minutes. The entire testing process routinely took less than 30 minutes from the point of sampling to the time that the final results are available.

CONCLUSIONS

The results described here demonstrate that monitoring the development of stress in bacteria is a fast and simple way to detect 10(3) CFUs/mL or more bacteria in complex cellular blood products such as PCs.

Rapid microbiological testing: monitoring the development of bacterial stress

The ability to respond to adverse environments effectively along with the ability to reproduce are sine qua non conditions for all sustainable cellular forms of life. Given the availability of an appropriate sensing modality, the ubiquity and immediacy of the stress response could form the basis for a new approach for rapid biological testing. We have found that measuring the dielectric permittivity of a cellular suspension, an easily measurable electronic property, is an effective way to monitor the response of bacterial cells to adverse conditions continuously. The dielectric permittivity of susceptible and resistant strains of Escherichia coli and Staphylococcus aureus, treated with gentamicin and vancomycin, were measured directly using differential impedance sensing methods and expressed as the Normalized Impedance Response (NIR). These same strains were also heat-shocked and chemically stressed with Triton X-100 or H(2)O(2). The NIR profiles obtained for antibiotic-treated susceptible organisms showed a strong and continuous decrease in value. In addition, the intensity of the NIR value decrease for susceptible cells varied in proportion to the amount of antibiotic added. Qualitatively similar profiles were found for the chemically treated and heat-shocked bacteria. In contrast, antibiotic-resistant cells showed no change in the NIR values in the presence of the drug to which it is resistant. The data presented here show that changes in the dielectric permittivity of a cell suspension are directly correlated with the development of a stress response as well as bacterial recovery from stressful conditions. The availability of a practical sensing modality capable of monitoring changes in the dielectric properties of stressed cells could have wide applications in areas ranging from the detection of bacterial infections in clinical specimens to antibiotic susceptibility testing and drug discovery.

Bacterial contamination of platelets

Bacterial contamination of platelet products, both single donor apheresis platelet units and whole blood-derived platelet pools, continues to occur despite preventive measures. While some advances have been made in decreasing the rate of bacterial contamination of platelet units, particularly through diversion methods and early culture, a great deal remains to be done to eliminate the problem. Diversion methods have decreased contamination rates associated with skin commensal organisms. Culture methods are now widely used and many at-issue detection methods have been developed or are undergoing development. This article reviews the current developments and the challenges that remain to minimize and detect bacterial contamination of platelet products.