Rate of growth of Pseudomonas fluorescens in donated blood

Coagulation function of never frozen liquid plasma stored for 40 days

BACKGROUND

Never frozen liquid plasma (LP) has limited shelf life versus fresh frozen plasma (FFP) or plasma frozen within 24 h (PF24). Previous studies showed decreasing factor activities after Day (D)14 in thawed FFP but no differences between LP and FFP until D10. This study examined LP function through D40.

STUDY DESIGN AND METHODS

FFP and PF24 were stored at -20°C until assaying. LP was assayed on D5 then stored (4°C) for testing through D40. A clinical coagulation analyzer measured Factor (F)V, FVIII, fibrinogen, prothrombin time (PT), and activated partial thromboplastin time (aPTT). Thromboelastography (TEG) and thrombogram measured functional coagulation. Ristocetin cofactor assay quantified von Willebrand factor (vWF) activity. Residual platelets were counted.

RESULTS

FV/FVIII showed diminished activity over time in LP, while PT and aPTT both increased over time. LP vWF declined significantly by D7. Fibrinogen remained high through D40. Thrombin lagtime was delayed in LP but consistent to D40, while peak thrombin was significantly lower in LP but did not significantly decline over time. TEG R-time and angle remained constant. LP and PF24 (with residual platelets) had initially higher TEG maximum amplitudes (MA), but by D14 LP was similar to FFP.

CONCLUSION

Despite significant declines in some factors in D40 LP, fibrinogen concentration and TEG MA were stable suggesting stored LP provides fibrinogen similarly to frozen plasmas even at D40. LP is easier to store and prepare for prehospital transfusion, important benefits when the alternative is crystalloid.

Bacterial and Protozoan Lipoxygenases Could be Involved in Cell-to-Cell Signaling and Immune Response Suppression

Lipoxygenases are found in animals, plants, and fungi, where they are involved in a wide range of cell-to-cell signaling processes. The presence of lipoxygenases in a number of bacteria and protozoa has been also established, but their biological significance remains poorly understood. Several hypothetical functions of lipoxygenases in bacteria and protozoa have been suggested without experimental validation. The objective of our study was evaluating the functions of bacterial and protozoan lipoxygenases by evolutionary and taxonomic analysis using bioinformatics tools. Lipoxygenase sequences were identified and examined using BLAST, followed by analysis of constructed phylogenetic trees and networks. Our results support the theory on the involvement of lipoxygenases in the formation of multicellular structures by microorganisms and their possible evolutionary significance in the emergence of multicellularity. Furthermore, we observed association of lipoxygenases with the suppression of host immune response by parasitic and symbiotic bacteria including dangerous opportunistic pathogens.

Sonication culture improves microbiological diagnosis of modular megaprostheses

Modular megaprostheses are known for high infection rates followed by high rates of revisions. Microbial biofilms growing adherently on prosthetic surfaces may inhibit the detection of the pathogens causing prosthetic joint infections. We sought to answer the following questions: Does sonication culture (SC) improve the microbiological diagnosis of periprosthetic infections of megaprostheses compared to conventional tissue culture (TC)? Which pathogens were detected on the surface of megaprostheses with either SC or TC and do the findings help to identify low-grade infections? Included were 31 patients with modular megaprostheses, whose implant had been explanted due to suspected joint infection or revision surgery. SCs were performed according to the protocol by Trampuz et al. The diagnosis of infection was evaluated according to the definition of the Musculoskeletal Infection Society. The sensitivity of SC was 91.3% compared to 52.2% for TC and the specificity was 100% for SC and TC (p = 0.004). Under preoperative antibiotic therapy, the sensitivity of SC was 83.3% while the sensitivity of TC was 50%. Without preoperative antibiotic therapy the sensitivity of SC was 100% compared to 54.5% for TC. In nine cases, SCs detected microorganisms, while TC was negative. Detected bacteria were Staphylococcus epidermidis in four, Micrococcus species in one, Finegoldia magna in one, Brevibacterium casei in one, Pseudomonas fluorescens in one, and Enterococcus faecium in one. SC is a reliable method for dislodging pathogens from orthopedic implants. The SC of modular megaprostheses showed significantly higher pathogen detection than the periprosthetic TC, especially for low virulence pathogens. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1383-1387, 2017.

Pseudomonas fluorescens contamination of a feline packed red blood cell unit and studies of canine units

Background: While screening programs have reduced the risk of infectious disease transmission by donors in human and veterinary blood banking, bacterial contamination of blood products has emerged as a major complication in human medicine.

Objectives: To describe a Pseudomonas fluorescens (Pf)‐contaminated feline packed RBC (pRBC) unit and experimentally investigate Pf‐contaminated canine pRBCs.

Methods: Canine pRBCs were inoculated with Pf‐rich pRBCs from the sentinel feline unit and stored at 4°C or 20°C for 72 hours. Aliquots from the pRBCs were serially evaluated by microscopy, culture, and a eubacterial 16S rRNA real‐time PCR assay.

Results: One Pf‐contaminated feline unit turned black after 22 days of storage and was removed from the blood bank; a source was not found, and no other contaminated units were identified. Canine pRBCs spiked with 5 or 25 μL of the sentinel unit became culture‐ and/or 16S PCR‐positive at ≥8 hours at 20°C and 48 hours at 4°C and developed a color change at ≥24 hours. Sensitivity studies indicated that without incubation, inoculation of ≥100 μL Pf‐rich pRBCs was necessary for a positive 16S PCR test result.

Conclusions: P. fluorescens grows in stored pRBCs slowly at 4°C and rapidly at 20°C. Screening of blood products for color change, estimating bacterial concentration with microscopy, and 16S PCR testing are simple and fast ways to detect bacteria in stored blood. Aseptic collection, temperature‐controlled storage, and regular visual monitoring of stored units is recommended. Discolored units should not be transfused, but examined for bacterial contamination or other blood product quality problems.

Prevention of Yersinia enterocolitica, Pseudomonas fluorescens, and Pseudomonas putida outgrowth in deliberately inoculated blood by a novel pathogen-reduction process

BACKGROUND

Yersinia enterocolitica, Pseudomonas fluorescens, and P. putida are responsible for a significant amount of the bacterial sepsis cases attributed to RBC transfusions. INACTINE is a pathogen-reduction process for RBCs, which consists of incubation of RBCs with PEN110 (proprietary compound) followed by automated washing of the RBCs. INACTINE is an electrophilic agent, which inactivates a wide range of viruses and WBCs by disruption of nucleic acid replication. The present study investigated the effect of the PEN110 process on Y. enterocolitica, P. fluorescens, and P. putida.

STUDY DESIGN AND METHODS

Identical units of reduced CPD/ADSOL additive solution (AS-1) or CP2D/Nutricel additive solution (AS-3) RBCs were inoculated with 10 to 100 CFU per mL of either Y. enterocolitica, P. fluorescens, or P. putida. The control units were put on storage immediately after the bacterial spike. The test units were subjected to the PEN110 process and then stored. Sham control units were processed the same way as test units without addition of PEN110. Bacterial titer in all units was monitored during the 6-week storage period.

RESULTS

No bacteria were detected in any of the RBC units (n = 9 for each microorganism) prepared using the PEN110 process throughout 6 weeks of storage. Substantial bacterial growth occurred in all control and in a majority of sham control units (11 out of 15 experiments). The bacterial inactivation by the INACTINE process was found to be equally effective in CPD/AS-1 and CP2D/AS-3 RBC units.

CONCLUSION

The INACTINE process effectively prevented the outgrowth of Y. enterocolitica, P. fluorescens, and P. putida deliberately inoculated into WBC-reduced CPD/AS-1 and CP2D/AS-3 RBCs. The results demonstrated the crucial bactericidal role of PEN110 in the INACTINE process.

Failure to kill Yersinia enterocolitica by plasma diluted to the concentration found in red cell units

The possibility that the use of additive solutions for red cell storage might impair the ability of plasma to kill Yersinia enterocolitica was investigated by studying killing of Y enterocolitica by neat and diluted plasma. The ability of neat citrated plasma to kill complement sensitive organisms was lost at around 26%, the dilution typically found in red cell units. These results should be considered in the light of evidence that killing in plasma is important in the protection of donated blood against growth of Y enterocolitica, and the observation that the increase in frequency of transfusion reactions caused by Y enterocolitica coincided with the widespread introduction of additive solutions. Taken together, these points support the suggestion that the introduction of additive solutions may have precipitated the problem of growth of Y enterocolitica in stored blood.