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Prax M, Spindler-Raffel E, McDonald CP, Bearne J, Satake M, Kozakai M, Rojo J, Hanschmann KMO, Lambrecht B, Grundmann U, O'Flaherty N, Klimek A, Bekeredjian-Ding I, Gathof BS, Störmer M, Süßner S, Renke C, Lee CK, Knabbe C, Vollmer T, Keil SD, Shipps ME, Wagner SJ, Jentsch U, Mpumlwana X, Cloutier M, Bringmann P, Lu T, Ramirez-Arcos S, Kou Y, Krut O. Establishment of transfusion-relevant bacteria reference strains for red blood cells. Vox Sang 2020; 116:692-701. [PMID: 33341965 DOI: 10.1111/vox.13057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Red blood cell concentrates (RBCC) are susceptible to bacterial contamination despite cold storage. A reliable evaluation of strategies to minimize the risk of RBCC-associated bacterial transmission requires the use of suitable reference bacteria. Already existing Transfusion-Relevant Bacteria Reference Strains (TRBRS) for platelet concentrates fail to grow in RBCC. Consequently, the ISBT TTID, Working Party, Bacterial Subgroup, conducted an international study on TRBRS for RBCC. MATERIALS AND METHODS Six bacterial strains (Listeria monocytogenes PEI-A-199, Serratia liquefaciens PEI-A-184, Serratia marcescens PEI-B-P-56, Pseudomonas fluorescens PEI-B-P-77, Yersinia enterocolitica PEI-A-105, Yersinia enterocolitica PEI-A-176) were distributed to 15 laboratories worldwide for enumeration, identification, and determination of growth kinetics in RBCC at days 7, 14, 21, 28, 35 and 42 of storage after low-count spiking (10-25 CFU/RBCC). RESULTS Bacterial proliferation in RBCC was obtained for most strains, except for S. marcescens, which grew only at 4 of 15 laboratories. S. liquefaciens, S. marcescens, P. fluorescens and the two Y. enterocolitica strains reached the stationary phase between days 14 and 21 of RBCC storage with a bacterial concentration of approximately 109 CFU/ml. L. monocytogenes displayed slower growth kinetics reaching 106 -107 CFU/ml after 42 days. CONCLUSION The results illustrate the importance of conducting comprehensive studies to establish well-characterized reference strains, which can be a tool to assess strategies and methods used to ameliorate blood safety. The WHO Expert Committee on Biological Standardization adopted the five successful strains as official RBCC reference strains. Our study also highlights the relevance of visual inspection to interdict contaminated RBC units.
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Affiliation(s)
| | - Eva Spindler-Raffel
- Institut für Lebensmittelsicherheit/Food Safety, Hochschule, Geisenheim University, Geisenheim, Germany
| | | | | | | | | | - Julieta Rojo
- Centro Nacional de la Transfusión Sanguínea, Mexico, Mexico
| | | | | | - Udo Grundmann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | | | - Agata Klimek
- Irish Blood Transfusion Service, Dublin, Ireland
| | | | - Birgit S Gathof
- Department of Transfusion Medicine, University Hospital of Cologne, Cologne, Germany
| | - Melanie Störmer
- Department of Transfusion Medicine, University Hospital of Cologne, Cologne, Germany
| | - Susanne Süßner
- Red Cross Transfusion Service of Upper Austria, Austrian Red Cross, Linz, Austria
| | - Claudia Renke
- Red Cross Transfusion Service of Upper Austria, Austrian Red Cross, Linz, Austria
| | - Cheuk-Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - Cornelius Knabbe
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Tanja Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | | | | | - Stephen J Wagner
- Holland Laboratory, Transfusion Innovation Department, American Red Cross, Rockville, MD, USA
| | - Ute Jentsch
- Constantia Kloof, South African National Blood Service, Johannesburg, South Africa
| | - Xoliswa Mpumlwana
- Constantia Kloof, South African National Blood Service, Johannesburg, South Africa
| | | | | | - Thea Lu
- Cerus Corporation, Concord, CA, USA
| | - Sandra Ramirez-Arcos
- Canadian Blood Service, Ottawa, ON, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | | | - Oleg Krut
- Paul-Ehrlich-Institut, Langen, Germany
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