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Chen H, Zheng S, Zhang Y, Tang Q, Zhang R, Chen Y, Wu M, Liu L. Visual Detection of LPS at the Femtomolar Level Based on Click Chemistry-Induced Gold Nanoparticles Electrokinetic Accumulation. Anal Chem 2024; 96:6995-7004. [PMID: 38666367 DOI: 10.1021/acs.analchem.4c00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Lipopolysaccharide (LPS) presents a significant threat to human health. Herein, a novel method for detecting LPS was developed by coupling hybridization chain reaction (HCR), gold nanoparticles (AuNPs) agglutination (AA) triggered by a Cu(I)-catalyzed azide-alkyne cycloaddition click chemistry (CuAAC), and electrokinetic accumulation (EA) in a microfluidic chip, termed the HCR-AA-EA method. Thereinto, the LPS-binding aptamer (LBA) was coupled with the AuNP-coated Fe3O4 nanoparticle, which was connected with the polymer of H1 capped on CuO (H1-CuO) and H2-CuO. Upon LPS recognition by LBA, the polymers of H1- and H2-CuO were released into the solution, creating a "one LPS-multiple CuO" effect. Under ascorbic acid reduction, CuAAC was initiated between the alkyne and azide groups on the AuNPs' surface; then, the product was observed visually in the microchannel by EA. Finally, LPS was quantified by the integrated density of AuNP aggregates. The limit of detections were 29.9 and 127.2 fM for water samples and serum samples, respectively. The levels of LPS in the injections and serum samples by our method had a good correlation with those from the limulus amebocyte lysate test (r = 0.99), indicating high accuracy. Remarkably, to popularize our method, a low-cost, wall-power-free portable device was developed, enabling point-of-care testing.
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Affiliation(s)
- Hanren Chen
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Shiquan Zheng
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Yitong Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Qing Tang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Runhui Zhang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Yue Chen
- Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan 442000, China
| | - Meiming Wu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lihong Liu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
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Na B, Lee J, Chang HE, Park E, Park S, Lee J, Oh S, Shin DW, Hong YJ, Park KU. Verification of a method using magnetic bead enrichment and nucleic acid extraction to improve the molecular detection of bacterial contamination in blood components. Microbiol Spectr 2024; 12:e0276023. [PMID: 38319091 PMCID: PMC10913752 DOI: 10.1128/spectrum.02760-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Bacterial contamination of blood products poses a significant risk in transfusion medicine. Platelets are particularly vulnerable to bacterial growth because they must be stored at room temperature with constant agitation for >5 days. The limitations of bacterial detection using conventional methods, such as blood cultures and lateral flow assays, include the long detection times, low sensitivity, and the requirement for substantial volumes of blood components. To address these limitations, we assessed the performance of a bacterial enrichment technique using antibiotic-conjugated magnetic nanobeads (AcMNBs) and real-time PCR for the detection of bacterial contamination in plasma. AcMNBs successfully captured >80% of four bacterial strains, including Staphylococcus aureus, Bacillus cereus, Escherichia coli, and Klebsiella pneumoniae, in both plasma and phosphate-buffered saline. After 24-h incubation with bacterial enrichment, S. aureus and B. cereus were each detected at 101 CFU/mL in all trials (5/5), E. coli at 101 CFU/mL in 1/5 trials, and K. pneumoniae at 10² CFU/mL in 4/5 trials. Additionally, without incubation, the improvement was also achieved in samples with bacterial enrichment, S. aureus at 10² CFU/mL and B. cereus at 101 CFU/mL in 1/5 trials each, E. coli at 10³ CFU/mL in 3/5 trials, and K. pneumoniae at 10¹ CFU/mL in 2/5 trials. Overall, the findings from this study strongly support the superiority of bacterial enrichment in detecting low-level bacterial contamination in plasma when employing AcMNBs and PCR.IMPORTANCEThe study presents a breakthrough approach to detect bacterial contamination in plasma, a critical concern in transfusion medicine. Traditional methods, such as blood cultures and lateral flow assays, are hampered by slow detection times, low sensitivity, and the need for large blood sample volumes. Our research introduces a novel technique using antibiotic-conjugated magnetic nanobeads combined with real-time PCR, enhancing the detection of bacteria in blood products, especially platelets. This method has shown exceptional efficiency in identifying even low levels of four different species of bacteria in plasma. The ability to detect bacterial contamination rapidly and accurately is vital for ensuring the safety of blood transfusions and can significantly reduce the risk of infections transmitted through blood products. This advancement is a pivotal step in improving patient outcomes and elevating the standards of care in transfusion medicine.
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Affiliation(s)
- Byungjoon Na
- KingoBio Inc. Research Center, Seoul, South Korea
| | - Jinyeop Lee
- KingoBio Inc. Research Center, Seoul, South Korea
| | | | - Eunseon Park
- KingoBio Inc. Research Center, Seoul, South Korea
| | - Sojin Park
- KingoBio Inc. Research Center, Seoul, South Korea
| | | | - Sujin Oh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Woo Shin
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yun Ji Hong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyoung Un Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Lu TC, Yang YJ, Zhong Y, Qiu QZ, Chen ZH, Chen YZ, Lei Y, Liu AL. Simultaneous detection of C-reactive protein and lipopolysaccharide based on a dual-channel electrochemical biosensor for rapid Gram-typing of bacterial sepsis. Biosens Bioelectron 2024; 243:115772. [PMID: 37879271 DOI: 10.1016/j.bios.2023.115772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/15/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Sepsis is a life-threatening multi-organ failure syndrome, with bacterial infections being the most common cause. Rapid Gram-typing is imperative to assist in antibiotic intervention. C-reactive protein (CRP) and lipopolysaccharide (LPS) are effective biomarkers for discerning the Gram type of bacteria but differ by several orders of magnitude in clinical detection, thereby impeding their simultaneous detection. And two independent methods are time-consuming and laborious. In this study, a dual-channel electrochemical biosensor was developed for simultaneous detection of LPS and CRP. Under optimal conditions, linear ranges of LPS (0.5-1000 pg/mL) and CRP (0.1-20 μg/mL) were obtained in line with the clinical evaluation scopes. In simulated sample tests, Gram-positive, Gram-negative, and healthy plasma samples were clearly distinguished by the developed biosensors, and these results were consistent with that of enzyme-linked immunosorbent assay (ELISA). In addition, the results of the plasma samples tested by the electrochemical biosensor matched those derived from blood cultures in the laboratory. Collectively, the electrochemical biosensor was expected to provide the scientific basis for the rapid Gram-typing and point-of-care detection of bacterial sepsis.
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Affiliation(s)
- Tai-Cheng Lu
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China
| | - Yuan-Jie Yang
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China
| | - Yu Zhong
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China
| | - Qing-Zhen Qiu
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China
| | - Zhen-Hua Chen
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China
| | - Yuan-Zhong Chen
- Fujian Institute of Hematology, The Affiliated Union Hospital of Fujian Medical University, Fuzhou, 350000, China.
| | - Yun Lei
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China.
| | - Ai-Lin Liu
- Department of Pharmaceutical Analysis, Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Faculty of Pharmacy, Fujian Medical University, Fuzhou, 350122, China.
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4
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Walker BS, Schmidt RL, White SK, Metcalf RA. Meta-analysis of bacterial growth characteristics in platelet components: Refining the inputs of a simulation analysis comparing the relative safety of testing strategies. Transfusion 2023; 63:1719-1727. [PMID: 37589199 DOI: 10.1111/trf.17497] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The relative safety of bacterial risk control strategies for platelets that include culture with or without rapid testing has been compared using simulation analysis. A wide range of bacterial lag and doubling times were included. However, published data on growth rates are available and these data have not been synthesized. We conducted a systematic review and meta-analysis to estimate growth rates and used these estimates to refine a comparative safety analysis of bacterial risk control strategies in the FDA guidance STUDY DESIGN AND METHODS: Data were extracted from published studies on bacterial growth rates in platelet components during storage. These data were used to estimate the practical range of growth rates. This refined the inputs for a simulation model comparing the safety of the testing strategies. RESULTS In total, 108 growth curves for 11 different aerobic organisms were obtained. Doubling times ranged from 0.8 to 12 h, but the lower 90% range was approximately 1-5 h. The revised comparative safety simulation using the narrower 1-5-h range showed similar rankings to the prior simulation, with 48-h large-volume delayed sampling with 7-day expiration (48C-7) demonstrating the lowest-ranking relative performance at the 103 and 105 colony forming unit (CFU)/mL exposure thresholds. DISCUSSION This was a two-step study. First, meta-analysis of published data on aerobic bacterial growth rates in stored platelets showed the vast majority of doubling times were 1-5 h. Next, an updated comparative safety simulation yielded similar results to a prior study, with 48C-7 showing the least favorable relative safety performance.
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Affiliation(s)
| | - Robert L Schmidt
- ARUP Laboratories, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Sandra K White
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Ryan A Metcalf
- ARUP Laboratories, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
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5
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Lee J, Abafogi AT, Oh S, Chang HE, Tepeng W, Lee D, Park S, Park KU, Hong YJ. Molecular detection of bacterial contamination in plasma using magnetic-based enrichment. Sci Rep 2022; 12:9151. [PMID: 35650226 PMCID: PMC9160056 DOI: 10.1038/s41598-022-12960-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Bacterial contamination of blood products is a major problem in transfusion medicine, in terms of both morbidity and mortality. Platelets (PLTs) are stored at room temperature (under constant agitation) for more than 5 days, and bacteria can thus grow significantly from a low level to high titers. However, conventional methods like blood culture and lateral flow assay have disadvantages such as long detection time, low sensitivity, and the need for a large volume of blood components. We used real-time polymerase chain reaction (PCR) assays with antibiotic-conjugated magnetic nanobeads (MNBs) to detect enriched Gram-positive and -negative bacteria. The MNBs were coated with polyethylene glycol (PEG) to prevent aggregation by blood components. Over 80% of all bacteria were captured by the MNBs, and the levels of detection were 101 colony forming unit [CFU]/mL and 102 CFU/mL for Gram-positive and -negative bacteria, respectively. The detection time is < 3 h using only small volumes of blood components. Thus, compared to conventional methods, real-time PCR using MNBs allows for rapid detection with high sensitivity using only a small volume of blood components.
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Affiliation(s)
- Jinyeop Lee
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, South Korea.,KingoBio Inc. Research Center, Suwon, South Korea
| | | | - Sujin Oh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Wu Tepeng
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, South Korea.,KingoBio Inc. Research Center, Suwon, South Korea
| | - Daekyu Lee
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Sungsu Park
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, South Korea. .,Department of Biophysics, Institute of Quantum Biophysics (IQB), Sungkyunkwan University, Suwon, South Korea.
| | - Kyoung Un Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yun Ji Hong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Satake M, Kozakai M, Matsumoto M, Matsubayashi K, Taira R, Goto N. Platelet safety strategies in Japan: impact of short shelf life on the incidence of septic reactions. Transfusion 2020; 60:731-738. [PMID: 32119134 DOI: 10.1111/trf.15733] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/17/2020] [Accepted: 01/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Transfusion-transmitted bacterial infections (TTBIs) often have serious consequences for patients. The Japanese Red Cross (JRC) has not implemented culture screening for platelet concentrate (PC), but it has maintained a shelf life of 85 hours for PC. STUDY DESIGN AND METHODS The JRC collected reports of suspected TTBI and investigated causal relationships using PC samples and patient blood samples. PCs showing apparent abnormalities were retrieved and cultured and analyzed for bacterial growth. RESULTS The JRC analyzed 86 samples available from 135 transfused PCs with suspected TTBIs that were collected over the past 12 years; 17 (19.8%) were culture-positive. One, 6, and 10 TTBIs developed in patients on Days 1, 2, and 3 after PC collection, respectively. Assuming that PC is transfused on the day of issue, the TTBI risk was fourfold higher on Day 3 than on Day 2, after adjusting the TTBI incidence for the number of PCs issued per day. Compared with the model of issuing all PCs on Day 3, issuing PCs with the current distribution of storage time could have decreased the TTBI incidence by 56%. During the past 8 years, the JRC retrieved 960 PC units because of apparent abnormalities, 2.8% of which were culture-positive. CONCLUSION The short shelf life of PC is associated with a low incidence of reported TTBIs, more than half of which occurred on Day 3 relative to earlier time points. Visual inspection of PC before transfusion is crucial in detecting bacterially contaminated PC despite its low positive predictive value.
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Affiliation(s)
- Masahiro Satake
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan.,Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
| | - Moe Kozakai
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
| | - Mami Matsumoto
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
| | | | - Rikizo Taira
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
| | - Naoko Goto
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
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7
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A Fatal Case of Septic Shock Secondary to Acinetobacter Bacteremia Acquired from a Platelet Transfusion. Case Rep Med 2019; 2019:3136493. [PMID: 32089699 PMCID: PMC7029672 DOI: 10.1155/2019/3136493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/05/2023] Open
Abstract
Background Transfusion of blood products is a frequent and often necessary lifesaving intervention. While changes to blood bank practices over the past several decades have reduced the infectious complications associated with transfusions, risks still exist. Septic transfusion reactions caused by bacterial contamination of blood products, especially platelets, still occur relatively frequently. Unfortunately, clinical recognition of septic transfusion reactions is difficult due to significant symptom, exam, and laboratory abnormality overlap between different types of transfusion reactions, as well as other conditions. Novel methods have been developed to detect blood product contamination but have yet to be widely implemented in the United States. Case Report A 67-year-old male with chronic thrombocytopenia was transfused with platelets prior to a planned procedure. Shortly afterwards, he developed fever and hypotension. He was transferred to the intensive care unit where he was treated with aggressive fluid resuscitation and broad-spectrum antibiotics. The patient went on to develop progressively worsening shock and profound disseminated intravascular coagulation. Blood cultures from the patient and the transfused platelets grew an Acinetobacter species. Despite aggressive resuscitative efforts and appropriate antibiotics, the patient died approximately 48 hours following the transfusion reaction. Conclusion We report a fatal case of septic shock associated with Acinetobacter bacteremia caused by platelet transfusion. Our review of the literature revealed only one other documented platelet transfusion associated fatality caused by Acinetobacter species. Novel pathogen reduction and contamination detection methods have been developed but have yet to be widely adopted in the United States.
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8
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Banerjee T, Tummala T, Elliott R, Jain V, Brantley W, Hadorn L, Santra S. Multimodal Magneto-Fluorescent Nanosensor for Rapid and Specific Detection of Blood-Borne Pathogens. ACS APPLIED NANO MATERIALS 2019; 2:5587-5593. [PMID: 34222829 PMCID: PMC8247792 DOI: 10.1021/acsanm.9b01158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Detection of bacterial contaminants in blood and platelet concentrates (PCs) continues to be challenging in clinical settings despite available current testing methods. At the same time, it is important to detect the low bacterial contaminants present at the time of transfusion. Herein, we report the design and synthesis of a dual-modal magneto-fluorescent nanosensor (MFnS) by integrating magnetic relaxation and fluorescence modalities for the wide-range detection of blood-borne pathogens. In this study, functional MFnS are designed to specifically detect Staphylococcus epidermidis and Escherichia coli, two of the predominant bacterial contaminants of PCs. Specific interaction between the target pathogen and functional MFnS resulted in the change of water proton's magnetic relaxation time (T2 MR), indicative of sensitive detection of the target bacteria from low to high colony forming unit (CFU). In addition, the acquired MR signal of MFnS further facilitated the quantitative assessment of the slow and fast growth kinetics of target pathogens. Moreover, the presence of fluorescence modality in MFnS allowed for the detection of multi-contaminants. The bacterial detection was also performed in complex media including whole blood and platelet concentrates, which further demonstrated for it's robust detection sensitivity. Overall, our study indicated that the designer MFnS will have potential for the wide-range detection of blood-borne pathogens, and features desirable qualities including timeliness, sensitivity and, specificity.
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Affiliation(s)
- Tuhina Banerjee
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
| | - Tanuja Tummala
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
| | - Rebekah Elliott
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
| | - Vedant Jain
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
| | - Wesley Brantley
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
| | - Laci Hadorn
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
| | - Santimukul Santra
- Department of Chemistry, Pittsburg State University, 1701 S. Broadway Street, Pittsburg, KS 66762, USA
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9
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Existing and Emerging Blood-Borne Pathogens: Impact on the Safety of Blood Transfusion for the Hematology/Oncology Patient. Hematol Oncol Clin North Am 2019; 33:739-748. [PMID: 31466601 DOI: 10.1016/j.hoc.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Despite measures to mitigate risk of transfusion-transmitted infections, emerging agents contribute to morbidity and mortality. We outline the epidemiology, risk mitigation strategies, and impact on patients for Zika virus, bacteria, Babesia, and cytomegalovirus. Nucleic acid testing of blood has reduced risk of Zika infection and reduced transfusion-transmitted risk of Babesia. Other collection and testing measures have reduced but not eliminated the risk of sepsis from bacterially contaminated blood components. Cytomegalovirus has almost been eliminated by high-efficiency leukoreduction, but residual transmissions are difficult to distinguish from community-acquired infections and additional antibody testing of blood may confer further safety of susceptible recipients.
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10
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Levy JH, Neal MD, Herman JH. Bacterial contamination of platelets for transfusion: strategies for prevention. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2018; 22:271. [PMID: 30367640 PMCID: PMC6204059 DOI: 10.1186/s13054-018-2212-9] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/25/2018] [Indexed: 01/07/2023]
Abstract
Platelet transfusions carry greater risks of infection, sepsis, and death than any other blood product, owing primarily to bacterial contamination. Many patients may be at particular risk, including critically ill patients in the intensive care unit. This narrative review provides an overview of the problem and an update on strategies for the prevention, detection, and reduction/inactivation of bacterial contaminants in platelets. Bacterial contamination and septic transfusion reactions are major sources of morbidity and mortality. Between 1:1000 and 1:2500 platelet units are bacterially contaminated. The skin bacterial microflora is a primary source of contamination, and enteric contaminants are rare but may be clinically devastating, while platelet storage conditions can support bacterial growth. Donor selection, blood diversion, and hemovigilance are effective but have limitations. Biofilm-producing species can adhere to biological and non-biological surfaces and evade detection. Primary bacterial culture testing of apheresis platelets is in routine use in the US. Pathogen reduction/inactivation technologies compatible with platelets use ultraviolet light-based mechanisms to target nucleic acids of contaminating bacteria and other pathogens. These methods have demonstrated safety and efficacy and represent a proactive approach for inactivating contaminants before transfusion to prevent transfusion-transmitted infections. One system, which combines ultraviolet A and amotosalen for broad-spectrum pathogen inactivation, is approved in both the US and Europe. Current US Food and Drug Administration recommendations advocate enhanced bacterial testing or pathogen reduction/inactivation strategies (or both) to further improve platelet safety. Risks of bacterial contamination of platelets and transfusion-transmitted infections have been significantly mitigated, but not eliminated, by improvements in prevention and detection strategies. Regulatory-approved technologies for pathogen reduction/inactivation have further enhanced the safety of platelet transfusions. Ongoing development of these technologies holds great promise.
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Affiliation(s)
- Jerrold H Levy
- Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA.
| | - Matthew D Neal
- University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jay H Herman
- Thomas Jefferson University Hospital, 111 S. 11th Street, Philadelphia, PA, 19107, USA
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11
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Störmer M, Wood EM, Gathof B. Microbial safety of cellular therapeutics-lessons from over ten years’ experience in microbial safety of platelet concentrates. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/voxs.12452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Melanie Störmer
- Transfusion Medicine; University Hospital Cologne; Cologne Germany
| | - Erica M. Wood
- Transfusion Research Unit; Department of Epidemiology and Preventive Medicine; Monash University; Melbourne VIC Australia
| | - Birgit Gathof
- Transfusion Medicine; University Hospital Cologne; Cologne Germany
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12
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Vollmer T, Dabisch‐Ruthe M, Weinstock M, Knabbe C, Dreier J. Late sampling for automated culture to extend the platelet shelf life to 5 days in Germany. Transfusion 2018; 58:1654-1664. [DOI: 10.1111/trf.14617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/22/2018] [Accepted: 02/26/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Tanja Vollmer
- Herz‐ und Diabeteszentrum Nordrhein‐Westfalen, Universitaetsklinik der Ruhr‐Universität BochumBad Oeynhausen Germany
| | - Mareike Dabisch‐Ruthe
- Herz‐ und Diabeteszentrum Nordrhein‐Westfalen, Universitaetsklinik der Ruhr‐Universität BochumBad Oeynhausen Germany
| | - Melanie Weinstock
- Herz‐ und Diabeteszentrum Nordrhein‐Westfalen, Universitaetsklinik der Ruhr‐Universität BochumBad Oeynhausen Germany
| | - Cornelius Knabbe
- Herz‐ und Diabeteszentrum Nordrhein‐Westfalen, Universitaetsklinik der Ruhr‐Universität BochumBad Oeynhausen Germany
| | - Jens Dreier
- Herz‐ und Diabeteszentrum Nordrhein‐Westfalen, Universitaetsklinik der Ruhr‐Universität BochumBad Oeynhausen Germany
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13
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Chetouane Y, Dubourg G, Gallian P, Delerce J, Levasseur A, Flaudrops C, Chabrière E, Chiaroni J, Raoult D, Camoin-Jau L. In vitro detection of bacterial contamination in platelet concentrates by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a preliminary study. J Med Microbiol 2017; 66:1523-1530. [PMID: 28984240 DOI: 10.1099/jmm.0.000533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Platelet concentrates are at risk of transfusion-related sepsis. The microbial detection methods currently available have reached their limits, as they do not completely prevent transfusion-related bacterial contamination.The aim of this study was to develop a new strategy to detect the risk of platelet transfusion-related bacterial contamination using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). METHODOLOGY In vitro, platelet concentrates were seeded with known concentrations of bacterial strains. Protein mass profiles were acquired by using a Microflex MALDI-TOF instrument. Dedicated 'Platelet' software was used as a spectrum subtraction tool to reveal specific peaks caused by the presence of pathogens in samples. RESULTS The MALDI-TOF spectra of platelets were characterized and the reproducibility over time, regardless of the blood donor, was demonstrated with a positive predictive value of 100 %. In addition, the negative predictive value of the total number of specific peaks to predict contamination was 100 %. CONCLUSION Detecting bacteria in platelet concentrates using the MALDI-TOF approach and analysing spectra with the Platelet software present the advantage of combining the precocity of results and sufficient sensitivity (10 c.f.u. ml-1). Further research will be conducted to compare this novel method with the current conventional method in order to validate our results, the objective being to reduce the risk of platelet transfusion-related bacterial contamination.
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Affiliation(s)
- Yasmine Chetouane
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Gregory Dubourg
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Pierre Gallian
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France.,Etablissement Français du Sang (EFS), La Plaine Saint-Denis, France
| | - Jeremy Delerce
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Anthony Levasseur
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Christophe Flaudrops
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Eric Chabrière
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Jacques Chiaroni
- Etablissement Français du Sang (EFS), La Plaine Saint-Denis, France.,Aix-Marseille Université, CNRS, EFS, ADES UMR 7268, Marseille, France
| | - Didier Raoult
- Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
| | - Laurence Camoin-Jau
- AP-HM, Laboratoire d'Hématologie, CHU Timone, Marseille, France.,Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, CNRS UMR 7278, IRD 198, Marseille, France
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Vollmer T, Schmidt M, Hourfar K, Schottstedt V, Pichl L, Gubbe K, Knabbe C, Dreier J. Establishment of a proficiency panel for an external quality assessment programme for the detection of bacterial contamination in platelet concentrates using rapid and cultural detection methods. Vox Sang 2016; 110:336-43. [PMID: 26848941 DOI: 10.1111/vox.12384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Platelet concentrates (PCs) are the main focus regarding the residual risk of transfusion-transmitted bacterial infections. Rapid screening methods for bacterial detection in platelets have been optimized over the last decade, but their external evaluation represents a complicated process. We developed a new type of proficiency panel for bacterial detection in PCs using currently available screening methods (especially rapid methods) suitable for external quality assessment programmes (EQAP). METHODS PC samples were inoculated with different bacteria at two concentrations (10E+03 CFU/ml, 10E+05 CFU/ml) and stored under temperature-controlled conditions (1-5 days). Bacterial growth was further prevented by the addition of 0-20 μg/ml cotrimoxazole. Samples were analysed prior to and after storage using rapid detection methods (Bactiflow (BF), bacteria-generic NAT) and cultural methods to determine the influence of storage and antibiotic treatment on bacterial counts and the result outcome. A pilot EQAP was performed with four participants. RESULTS Testing under the evaluated conditions demonstrated that bacterial counts remained constant prior to and after storage. The supplementation of 10 μg/ml cotrimoxazole did not influence bacterial detection using the two rapid detection methods BF and NAT. Furthermore, the detection of bacteria using cultural methods is still possible despite of antibiotic supplementation. The pilot EQAP confirmed these results. A storage time of up to 3 days proved practicable, showing no considerable influence on bacterial count and outcome of test results. CONCLUSION The established proficiency panel provided PC matrix-conform samples with stabilized bacterial counts which can be analysed in parallel by rapid and cultural detection methods.
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Affiliation(s)
- T Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - M Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - K Hourfar
- Institute of Transfusion Medicine and Immunohematology, German Red Cross, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - V Schottstedt
- German Red Cross Blood Transfusion Service West, Central Laboratory, Hagen, Germany
| | - L Pichl
- German Red Cross Blood Transfusion Service West, Central Laboratory, Hagen, Germany
| | - K Gubbe
- DRK Blutspendedienst Nord-Ost gemeinnützige GmbH, Plauen, Germany
| | - C Knabbe
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - J Dreier
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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15
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Vollmer T, Knabbe C, Geilenkeuser WJ, Schmidt M, Dreier J. Bench Test for the Detection of Bacterial Contamination in Platelet Concentrates Using Rapid and Cultural Detection Methods with a Standardized Proficiency Panel. Transfus Med Hemother 2015; 42:220-5. [PMID: 26557813 DOI: 10.1159/000437396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The most frequent infectious complication in transfusion therapy in developed countries is related to the bacterial contamination of platelet concentrates (PCs). Rapid and cultural screening methods for bacterial detection in platelets are available, but external performance evaluation, especially of rapid methods, has been difficult to realize so far. Here we summarize the results of three individual collaborative trials using an external quality assessment program (EQAP) for the application of current rapid and cultural screening methods. METHODS Three different modules were available for the detection of bacterial contamination: module 1: rapid methods, module 2: culture methods, module 3: bacterial identification methods. The sample set-up included up to six different bacterial strains, 1-2 negative samples and 4-6 positive samples with stabilized bacterial cell counts (approximately 10(3)/10(4)/10(5) CFU/ml). Time schedule for testing was limited (module 1: 6 h, module 2 and 3: 7 days). RESULTS Samples of module 1 were analyzed with two different rapid methods (BactiFlow, NAT). The results of the three individual collaborative trials showed that all participants detected the negative samples with both assays correctly. Samples spiked with 10(4) to 10(5) CFU/ml of bacteria obtained positive results with both rapid screening methods, whereas samples spiked with only 10(3) CFU/ml disclosed a lower number of correctly identified positive results by NAT (86.6-93.8% sensitivity) compared to BactiFlow (100% sensitivity). The results for modules 2 and 3 revealed a 100% diagnostic sensitivity and specificity in all three collaborative trials. CONCLUSION This proficiency panel facilitates the verification of the analytical sensitivity of rapid and cultural bacterial detection systems under controlled routine conditions. The concept of samples provided in this EQAP has three main advantages: i) samples can be examined by both rapid and culture methods, ii) the provided material is matrix-equivalent, and iii) the sample material is ready-to-use.
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Affiliation(s)
- Tanja Vollmer
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, Germany
| | - Cornelius Knabbe
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, Germany
| | | | - Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross, Johann Wolfgang Goethe University, Frankfurt/M., Germany
| | - Jens Dreier
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, Germany
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16
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El Ichi S, Leon F, Vossier L, Marchandin H, Errachid A, Coste J, Jaffrezic-Renault N, Fournier-Wirth C. Microconductometric immunosensor for label-free and sensitive detection of Gram-negative bacteria. Biosens Bioelectron 2014; 54:378-84. [DOI: 10.1016/j.bios.2013.11.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/18/2013] [Accepted: 11/05/2013] [Indexed: 12/11/2022]
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17
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Bioresponsive polymers for the detection of bacterial contaminations in platelet concentrates. N Biotechnol 2014; 31:150-5. [DOI: 10.1016/j.nbt.2013.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/09/2013] [Indexed: 02/02/2023]
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18
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Bacterial screening of platelet concentrates on day 2 and 3 with flow cytometry: the optimal sampling time point? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2014; 12:388-95. [PMID: 24887230 DOI: 10.2450/2014.0175-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/24/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is growing concern on the residual risk of bacterial contamination of platelet concentrates in Germany, despite the reduction of the shelf-life of these concentrates and the introduction of bacterial screening. In this study, the applicability of the BactiFlow flow cytometric assay for bacterial screening of platelet concentrates on day 2 or 3 of their shelf-life was assessed in two German blood services. The results were used to evaluate currently implemented or newly discussed screening strategies. MATERIALS AND METHODS Two thousand and ten apheresis platelet concentrates were tested on day 2 or day 3 after donation using BactiFlow flow cytometry. Reactive samples were confirmed by the BacT/Alert culture system. RESULTS Twenty-four of the 2,100 platelet concentrates tested were reactive in the first test by BactiFlow. Of these 24 platelet concentrates, 12 were false-positive and the other 12 were initially reactive. None of the microbiological cultures of the initially reactive samples was positive. Parallel examination of 1,026 platelet concentrates by culture revealed three positive platelet concentrates with bacteria detected only in the anaerobic culture bottle and identified as Staphylococcus species. Two platelet concentrates were confirmed positive for Staphylcoccus epidermidis by culture. Retrospective analysis of the growth kinetics of the bacteria indicated that the bacterial titres were most likely below the diagnostic sensitivity of the BactiFlow assay (<300 CFU/mL) and probably had no transfusion relevance. CONCLUSIONS The BactiFlow assay is very convenient for bacterial screening of platelet concentrates independently of the testing day and the screening strategy. Although the optimal screening strategy could not be defined, this study provides further data to help achieve this goal.
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Störmer M, Vollmer T. Diagnostic methods for platelet bacteria screening: current status and developments. ACTA ACUST UNITED AC 2013; 41:19-27. [PMID: 24659944 DOI: 10.1159/000357651] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/20/2013] [Indexed: 11/19/2022]
Abstract
Bacterial contamination of blood components and the prevention of transfusion-associated bacterial infection still remains a major challenge in transfusion medicine. Over the past few decades, a significant reduction in the transmission of viral infections has been achieved due to the introduction of mandatory virus screening. Platelet concentrates (PCs) represent one of the highest risks for bacterial infection. This is due to the required storage conditions for PCs in gas-permeable containers at room temperature with constant agitation, which support bacterial proliferation from low contamination levels to high titers. In contrast to virus screening, since 1997 in Germany bacterial testing of PCs is only performed as a routine quality control or, since 2008, to prolong the shelf life to 5 days. In general, bacterial screening of PCs by cultivation methods is implemented by the various blood services. Although these culturing systems will remain the gold standard, the significance of rapid methods for screening for bacterial contamination has increased over the last few years. These new methods provide powerful tools for increasing the bacterial safety of blood components. This article summarizes the course of policies and provisions introduced to increase bacterial safety of blood components in Germany. Furthermore, we give an overview of the different diagnostic methods for bacterial screening of PCs and their current applicability in routine screening processes.
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Affiliation(s)
- Melanie Störmer
- Institut für Transfusionsmedizin, Blutspendezentrale, Universitätsklinikum Köln, Bad Oeynhausen, Germany
| | - Tanja Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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20
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Zweitzig DR, Riccardello NM, Pester JM, Jeanmonod R, Kopnitsky MJ, O'Hara SM. A novel approach for rapid detection of bacterially contaminated platelet concentrates via sensitive measurement of microbial DNA polymerase activity. Transfusion 2013; 54:1642-51. [PMID: 24191780 DOI: 10.1111/trf.12487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 09/06/2013] [Accepted: 09/18/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Transfusion of bacterially contaminated platelet concentrates (PCs) can result in serious health consequences for the affected patient. Before being released from blood banking facilities, PCs are routinely screened for bacterial contamination by culture-based tests. However, culture-based PC screening methods require extended holding and incubation periods and are prone to false-negative results due to sampling error. Screening PCs closer to the time of transfusion using rapid point-of-issue tests represents an alternative approach; however, FDA-approved assays generally suffer from a lack of sensitivity. STUDY DESIGN AND METHODS Presented herein is the feasibility of a novel approach toward rapid, sensitive, and universal detection of bacterially contaminated PCs via selective measurement of microbial DNA polymerase activity. This approach is achieved using a differential cell lysis procedure in combination with enzymatic template generation and amplification (termed ETGA-PC assay). RESULTS Serial dilution spiking experiments revealed an approximate sensitivity of 30 to 200 colony-forming units (CFUs)/mL (mean, 85 CFUs/mL) for Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. An additional 22 clinically relevant strains of bacteria were also detected below 200 CFUs/mL after spiking into PC aliquots. Furthermore, the ETGA-PC assay was able to accurately monitor the presence and growth of seven clinically relevant bacterial species that were spiked into PC units. CONCLUSION Together, the data presented here demonstrate that the ETGA-PC assay is a feasible approach for rapid and sensitive detection of bacterially contaminated PCs. Experiments, aimed at simplification and/or automation of the assay procedure, are under way.
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21
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Developing new materials for paper-based diagnostics using electrospun nanofibers. Anal Bioanal Chem 2013; 406:3297-304. [DOI: 10.1007/s00216-013-7372-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/20/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022]
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Affiliation(s)
- C. P. McDonald
- National Bacteriology Laboratory; National Health Service Blood and Transplant; London; UK
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23
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Girona-Llobera E, Jimenez-Marco T, Galmes-Trueba A, Muncunill J, Serret C, Serra N, Sedeño M. Reducing the financial impact of pathogen inactivation technology for platelet components: our experience. Transfusion 2013; 54:158-68. [DOI: 10.1111/trf.12232] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 03/25/2013] [Accepted: 03/25/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Enrique Girona-Llobera
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
| | - Teresa Jimenez-Marco
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
| | - Ana Galmes-Trueba
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
| | - Josep Muncunill
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
| | - Carmen Serret
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
| | - Neus Serra
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
| | - Matilde Sedeño
- Fundació Banc de Sang i Teixits de les Illes Balears; Majorca Spain
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS); Majorca Spain
- Son Espases University Hospital; Majorca Spain
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Morel P, Naegelen C, Deschaseaux M, Bardiaux L. [Prevention of bacterial risk: pathogen inactivation/detection of bacteria]. Transfus Clin Biol 2013; 20:109-14. [PMID: 23622837 DOI: 10.1016/j.tracli.2013.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/27/2013] [Indexed: 11/30/2022]
Abstract
Bacterial contamination of blood products remains the most important infectious risk of blood transfusion in 2013. Platelet concentrates (PC) are in cause in the majority of the transfusion reaction due to bacterial contaminations. A lot of prevention methods have been developed over the last 10 years (pre-donation interview, skin decontamination, diversion of the first 30 mL of the donation, leuko-reduction...), they have focused on limiting the contamination of the donations and prevent the bacterial growth in donations and/or in the blood products. These measures were effective and led to significantly reducing the risk of adverse effects associated with bacterial growth. However, every year there are about six accidents (with a high level of imputability) and one death. The reduction of the bacterial risk remains a priority for the French Blood Establishment (EFS). The procedure for skin disinfection is going to be improved in order to further strengthen this crucial step to avoid the contamination of donation. Methods of pathogen inactivation applied to plasma and PC are available in France and their effectiveness is demonstrated on the bacterial risk. Methods for bacterial detection of PC are used in many countries now. Automated culture is the most common. Alternatives are now available in the form of rapid tests able to analyze the PC just before the delivery and avoid false negatives observed with automated culture. Assessments are under way to confirm these benefits in 2013.
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Affiliation(s)
- P Morel
- Établissement français du sang (EFS) Bourgogne-Franche-Comté, BP 1937, 1, boulevard Alexander-Fleming, 25020 Besançon cedex, France.
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25
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Harm SK, Delaney M, Charapata M, Aubuchon JP, Triulzi DJ, Yazer MH. Routine use of a rapid test to detect bacteria at the time of issue for nonleukoreduced, whole blood-derived platelets. Transfusion 2013; 53:843-50. [PMID: 22845719 DOI: 10.1111/j.1537-2995.2012.03818.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Pan Genera detection (PGD) test is used to screen platelet (PLT) products for bacterial contamination. We report the experience of using the PGD test on whole blood-derived PLTs (WBPs) at two large centralized transfusion services (CTS). STUDY DESIGN AND METHODS Records of PGD test results were retrospectively reviewed. The PGD test was performed on individual WBP units or pools of WBPs ranging in size from 2 to 6 units at the time of issue. Bacterial culture was performed on PLT products with positive PGD tests, and at one CTS, the available cocomponents. RESULTS A total of 70,561 WBP pools were screened with the PGD test. There were seven true-positive PGD tests and 242 false-positive tests (positive predictive value of PGD test, 2.81%). The overall contamination rate was 99 per 10(6) WBP pools (1:10,080; 95% confidence interval [CI], 40-204), and the false-positive rate was 3430 per 10(6) WBP pools (1:292; 95% CI, 3011-3890). All seven bacterial isolates were Gram positive. The median age of the individual WBP units in the seven contaminated pools was 5 days (range, 3-5 days) compared to 4 days (range, 1-5 days) in the false-positive pools (p=0.0012). The same bacteria isolated from a positive PLT pool also grew in one red blood cell cocomponent. CONCLUSION After testing more than 70,000 WBP pools at two large CTSs, the rate of contaminated WBP pools detected by the PGD test was 99 per 10(6) pools (1:10,080).
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Affiliation(s)
- Sarah K Harm
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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Schmidt M, Seifried E. Current status of bacterial detection in blood components - successes and challenges. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1751-2824.2012.01545.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Wang X, Li Y, Wang J, Wang Q, Xu L, Du J, Yan S, Zhou Y, Fu Q, Wang Y, Zhan L. A broad-range method to detect genomic DNA of multiple pathogenic bacteria based on the aggregation strategy of gold nanorods. Analyst 2012; 137:4267-73. [DOI: 10.1039/c2an35680e] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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28
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Vollmer T, Hinse D, Schottstedt V, Bux J, Tapernon K, Sibrowski W, Knabbe C, Dreier J. Inter-laboratory comparison of different rapid methods for the detection of bacterial contamination in platelet concentrates. Vox Sang 2011; 103:1-9. [DOI: 10.1111/j.1423-0410.2011.01572.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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29
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Tomasulo P, Su L. Is it time for new initiatives in the blood center and/or the hospital to reduce bacterial risk of platelets? Transfusion 2011; 51:2527-33. [DOI: 10.1111/j.1537-2995.2011.03423.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Jacobs MR, Smith D, Heaton WA, Zantek ND, Good CE. Detection of bacterial contamination in prestorage culture-negative apheresis platelets on day of issue with the Pan Genera Detection test. Transfusion 2011; 51:2573-82. [DOI: 10.1111/j.1537-2995.2011.03308.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ramírez-Arcos S, Kou Y, Mastronardi C, Perkins H, Goldman M. Bacterial screening of outdated buffy coat platelet pools using a culture system and a rapid immunoassay. Transfusion 2011; 51:2566-72. [DOI: 10.1111/j.1537-2995.2011.03311.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Li CZ, Vandenberg K, Prabhulkar S, Zhu X, Schneper L, Methee K, Rosser CJ, Almeide E. Paper based point-of-care testing disc for multiplex whole cell bacteria analysis. Biosens Bioelectron 2011; 26:4342-8. [DOI: 10.1016/j.bios.2011.04.035] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 04/13/2011] [Accepted: 04/21/2011] [Indexed: 10/18/2022]
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Petrik J, Coste J, Fournier-Wirth C. Advances in transfusion medicine in the first decade of the 21st century: Advances in miniaturized technologies. Transfus Apher Sci 2011; 45:45-51. [PMID: 21715229 DOI: 10.1016/j.transci.2011.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several miniaturized high throughput technologies have been developed in the last decade, primarily to study genomic structures and gene expression patterns under various conditions. At the same time, the microarrays, biosensors, integrated microfluidic lab-on-a-chip devices, next generation sequencing or digital PCR are gradually finding their diagnostic applications, although their suitability for specialised diagnostic fields has still to be assessed. In this review we discuss the potential applications of the new technologies to blood testing.
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Affiliation(s)
- J Petrik
- Scottish National Blood Transfusion Service, Edinburgh, UK.
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