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Quality validation of platelets obtained from the Haemonetics and Trima Accel automated blood-collection systems. Transfus Clin Biol 2020; 28:44-50. [PMID: 33227455 DOI: 10.1016/j.tracli.2020.10.010] [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: 09/07/2020] [Revised: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PA) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPA) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PA performed with Haemonetics and LRPA performed with Trima Accel cell separator. METHODS The qualities of platelets collected through PA and LRPA were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method. RESULTS During 5-day storage in LRPA, residual leucocytes were all <1.0×106, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5'-diphosphate (ADP) and collagen, and the extent of shape change and pO2 showed no statistically significant difference between PA and LRPA. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPA than in PA (71.78±6.92 vs. 64.10±7.42; P=0.002; 71.53±8.98 vs. 62.96±9.84; P=0.007; 68.05±7.28 vs. 57.76±6.80; P<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PA than in LRPA on days 0, 1, and 3. On day 5, the swirling score was higher in LRPA than in PA. The mean lactate levels had no statistically significant difference between PA and LRPA. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples. CONCLUSION Comparison of LRPA and PA products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.
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Abstract
Abstract
Platelet transfusion is a topic of common interest for many specialists involved in patient care, from laboratory staff to clinical physicians. Various aspects make this type of transfusion different from those of other blood components. In this review, the challenges in platelet transfusion practice that are relevant for laboratory colleagues will be discussed, highlighting how the biochemical and structural characteristics of these blood elements directly affect their function and consequently the clinical outcome. More than 1,300 platelet concentrates are transfused in Germany every day, and several types are offered by their respective manufacturers. We describe the technological advances in platelet concentrate production, with a focus on how the storage conditions of platelets can be improved. Laboratory quality assessment procedures for a safe transfusion are discussed in detail. For this purpose, we will refer to the Hemotherapy Directives (Richtlinie Hämotherapie) of the German Medical Association.
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Affiliation(s)
- Gianmatteo Vit
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University , German Red Cross Blood Service Baden-Württemberg - Hessen , Mannheim , Germany
- The Novo Nordisk Foundation Center for Protein Research, Protein Signaling Program , Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University , German Red Cross Blood Service Baden-Württemberg - Hessen , Mannheim , Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University , German Red Cross Blood Service Baden-Württemberg - Hessen , Mannheim , Germany
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Schmalz G, Hübscher AE, Angermann H, Schmidt J, Schmickler J, Legler TJ, Ziebolz D. High prevalence of periodontitis in blood donors and the possibility of questionnaire-based screening - results of a cross-sectional study. Transfus Med 2019; 29:394-400. [PMID: 31608531 DOI: 10.1111/tme.12633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/24/2019] [Accepted: 08/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Periodontitis is an inflammatory disease of high prevalence and, thus, of potential relevance to the management of blood donation. OBJECTIVES The aim of this cross-sectional study was to assess periodontal health and its associations to common blood parameters, as well as questionnaire-based periodontitis screening in blood donors. METHODS Generally healthy blood donors were recruited and underwent oral examination. Thereby, the decayed-, missing- and filled-teeth index (DMF-T) and periodontal status, including periodontal probing depth and clinical attachment loss, were assessed. Based on periodontal status, periodontitis severity was classified into no/mild, moderate or severe. Six yes/no questions regarding periodontal complaints and history were asked. Furthermore, common blood parameters were analysed. RESULTS A total of 148 participants (mean age 53·33 years) were included. The DMF-T was 15·28 ± 6·44. Nearly three quarters of participants suffered from a periodontitis (moderate 59·5% and severe 14·8%, total periodontitis 74·3%). Periodontitis severity was associated with the history of dental visits caused by periodontal complaints (P < 0·01) and previous periodontal therapy (P < 0·01). Only procalcitonin was initially found to be associated with blood periodontitis severity (P = 0·02). This observation was not confirmed by post-hoc testing between subgroups (Pi > 0·2). No further association between periodontitis severity and blood parameters was found (Pi > 0·05). CONCLUSION The prevalence of periodontitis in German blood donors is high. However, further studies with sensitive testing of bacteria in peripheral blood are required in order to determine the relevance of this result for the safety of blood components.
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Affiliation(s)
- G Schmalz
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - A E Hübscher
- Department. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Goettingen, Germany
| | - H Angermann
- Department. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Goettingen, Germany
| | - J Schmidt
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - J Schmickler
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - T J Legler
- Department of Transfusion Medicine, University Medical Centre Goettingen, Goettingen, Germany
| | - D Ziebolz
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Agzie M, Niguse S, Tsegay E, Kahsay G, Mahmud MA. Bacterial contaminants of stored blood and blood components ready for transfusion at blood banks in Mekelle, Northern Ethiopia. BMC Res Notes 2019; 12:169. [PMID: 30909947 PMCID: PMC6434862 DOI: 10.1186/s13104-019-4217-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 03/19/2019] [Indexed: 11/19/2022] Open
Abstract
Objective Bacterial contamination of donated blood and blood components is a major public health problem globally. The aim of the study was to evaluate the rate and spectrum of bacterial contaminations and antimicrobial susceptibility pattern of contaminants in stored blood and blood components. Results A total of 196 blood and blood components (concentrated red blood cells, fresh frozen plasma, and platelets) were included. Bacterial contamination was observed in 18 (9.2%) of the blood and blood components, of which 14 (77.8%) and 4 (22.2%) were gram positive and gram negative bacteria, respectively. The predominantly isolated bacteria were Coagulase-negative Staphylococcus, Bacillus spp., and Staphylococcus aureus. Majority of isolated gram-negative bacteria isolates showed resistance to tetracycline and doxycycline. Multidrug resistance was observed in 12 (66%) of the isolates.
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Affiliation(s)
| | - Selam Niguse
- Department of Medical Microbiology and Immunology, College of Health Science, Mekelle University, P. O. Box 1871, Mekelle, Ethiopia.
| | - Ephrem Tsegay
- Department of Medical Microbiology and Immunology, College of Health Science, Mekelle University, P. O. Box 1871, Mekelle, Ethiopia
| | - Getahun Kahsay
- Department of Medical Microbiology and Immunology, College of Health Science, Mekelle University, P. O. Box 1871, Mekelle, Ethiopia
| | - Mahmud Abdulkader Mahmud
- Department of Medical Microbiology and Immunology, College of Health Science, Mekelle University, P. O. Box 1871, Mekelle, Ethiopia
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Vossier L, Valera L, Leon F, Roche S, Piquer D, Rubrecht L, Favier C, Cremer GA, Pouzet A, Dagland T, Rihet S, Galea P, Farre C, Bonnet R, Jaffrézic-Renault N, Chaix C, Fareh J, Fournier-Wirth C. Combining culture and microbead-based immunoassay for the early and generic detection of bacteria in platelet concentrates. Transfusion 2018; 59:277-286. [PMID: 30430585 DOI: 10.1111/trf.15019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 07/16/2018] [Accepted: 07/22/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Despite current preventive strategies, bacterial contamination of platelets is the highest residual infectious risk in transfusion. Bacteria can grow from an initial concentration of 0.03-0.3 colony-forming units (CFUs)/mL up to 108 to 109 CFUs/mL over the product shelf life. The aim of this study was to develop a cost-effective approach for an early, rapid, sensitive, and generic detection of bacteria in platelet concentrates. STUDY DESIGN AND METHODS A large panel of bacteria involved in transfusion reactions, including clinical isolates and reference strains, was established. Sampling was performed 24 hours after platelet spiking. After an optimized culture step for increasing bacterial growth, a microbead-based immunoassay allowed the generic detection of bacteria. Antibody production and immunoassay development took place exclusively with bacteria spiked in fresh platelet concentrates to improve the specificity of the test. RESULTS Antibodies for the generic detection of either gram-negative or gram-positive bacteria were selected for the microbead-based immunoassay. Our approach, combining the improved culture step with the immunoassay, allowed sensitive detection of 1 to 10 CFUs/mL for gram-negative and 1 to 102 CFUs/mL for gram-positive species. CONCLUSION In this study, a new approach combining bacterial culture with immunoassay was developed for the generic and sensitive detection of bacteria in platelet concentrates. This efficient and easily automatable approach allows tested platelets to be used on Day 2 after collection and could represent an alternative strategy for reducing the risk of transfusion-transmitted bacterial infections. This strategy could be adapted for the detection of bacteria in other cellular products.
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Affiliation(s)
- Ludivine Vossier
- Pathogenesis and Control of Chronic Infections, EFS, Inserm, Université de Montpellier, Montpellier, France
| | - Lionel Valera
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Fanny Leon
- Pathogenesis and Control of Chronic Infections, EFS, Inserm, Université de Montpellier, Montpellier, France
| | - Stéphanie Roche
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Dominique Piquer
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Laetitia Rubrecht
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Christine Favier
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | | | - Agnès Pouzet
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Typhaine Dagland
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Stéphane Rihet
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Pascale Galea
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Carole Farre
- Institut des Sciences Analytiques, (CNRS-Université de Lyon 1-ENS), Lyon, France
| | - Romaric Bonnet
- Institut des Sciences Analytiques, (CNRS-Université de Lyon 1-ENS), Lyon, France
| | | | - Carole Chaix
- Institut des Sciences Analytiques, (CNRS-Université de Lyon 1-ENS), Lyon, France
| | - Jeannette Fareh
- Bio-Rad, R&D Marnes la Coquette, Steenvoorde and, Montpellier, France
| | - Chantal Fournier-Wirth
- Pathogenesis and Control of Chronic Infections, EFS, Inserm, Université de Montpellier, Montpellier, France
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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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Chetouane Y, Dubourg G, Gallian P, Flaudrops C, Chiaroni J, Chabrière E, Raoult D, Camoin-Jau L. Rapid identification of microorganisms from platelet concentrates by matrix-assisted laser desorption ionization time-of-flight mass spectrometry after short-term incubation on liquid medium. Transfusion 2017; 58:766-773. [PMID: 29193200 DOI: 10.1111/trf.14430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Platelets (PLTs) are especially affected by the risk of bacterial contamination. Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) is an accurate method for the routine identification of bacterial isolates in microbiology laboratories. We directly applied the MALDI-TOF method to bacterial detection in PLTs. In this study, we evaluated the sensitivity, specificity, and speed of a direct MALDI-TOF approach compared to the conventional method BACTEC. STUDY DESIGN AND METHODS Eight bacteria associated with PLT contamination, cited by the ISBT on transfusion-transmitted infectious diseases, were spiked into PLTs for a final concentration of approximately 100 CFU/bag (n = 5 for each strain). The PLTs were then agitated for 24 hours. One milliliter of PLTs was incubated in a shaker incubator for 8 hours at 37°C with 1 mL of trypticase soy broth (TSB). The spectra were analyzed using the MALDI Biotyper software. As a control, 8 mL of PLTs incubated into BACTEC bottles and a positive bottle were subcultured to ensure identification of bacterial growth. RESULTS Regardless of the strain of PLTs tested, MALDI-TOF analysis made detection and early identification possible at 8 hours. Analysis by BACTEC of PLTs infected with Escherichia coli, Bacillus cereus, and Providencia stuartii made early identification possible. For the remaining bacteria, the detection time by BACTEC was significantly longer than 8 hours. CONCLUSION We demonstrated the possibility of detecting bacteria in PLTs using a standardized culture step in TSB with MALDI-TOF, regardless of the strain, with the same specificity and analytical sensitivity and with a time to results of 12 hours. This direct method presented rapid and reliable results.
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Affiliation(s)
- Yasmine Chetouane
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille.,IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Gregory Dubourg
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille.,IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Pierre Gallian
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Etablissement Français du Sang (EFS), La Plaine Saint-Denis, France
| | - Christophe Flaudrops
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille.,IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Jacques Chiaroni
- Etablissement Français du Sang Alpes Méditerranée and Aix-Marseille Université, CNRS, EFS Biologie des Groupes Sanguins, ADES UMR 7268, Marseille, France
| | - Eric Chabrière
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille.,IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Didier Raoult
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille.,IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Laurence Camoin-Jau
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille.,IHU Méditerranée Infection, Pôle des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Assistance Publique Hôpitaux de Marseille, Laboratoire d'Hématologie, CHU Timone, Marseille, France
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D'Amico L, Ajami NJ, Adachi JA, Gascoyne PRC, Petrosino JF. Isolation and concentration of bacteria from blood using microfluidic membraneless dialysis and dielectrophoresis. LAB ON A CHIP 2017; 17:1340-1348. [PMID: 28276545 PMCID: PMC5894507 DOI: 10.1039/c6lc01277a] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A microfluidic system that combines membraneless microfluidic dialysis and dielectrophoresis to achieve label-free isolation and concentration of bacteria from whole blood is presented. Target bacteria and undesired blood cells are discriminated on the basis of their differential susceptibility to permeabilizing agents that alter the dielectrophoretic behavior of blood cells but not bacteria. The combined membraneless microdialysis and dielectrophoresis system isolated 79 ± 3% of Escherichia coli and 78 ± 2% of Staphylococcus aureus spiked into whole blood at a processing rate of 0.6 mL h-1. Collection efficiency was independent of the number of target bacteria up to 105 cells. Quantitative PCR analysis revealed that bacterial 16S rDNA levels were enriched more than 307-fold over human DNA in the fraction recovered from the isolation system compared with the original specimen. These data demonstrate feasibility for an instrument to accelerate the detection and analysis of bacteria in blood by first isolating and concentrating them in a microchamber.
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Affiliation(s)
- L D'Amico
- Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA. and Advanced Electrofluidic Systems, LLC, Houston, Texas, USA
| | - N J Ajami
- Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
| | - J A Adachi
- Department of Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P R C Gascoyne
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA and Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA and Advanced Electrofluidic Systems, LLC, Houston, Texas, USA
| | - J F Petrosino
- Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
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Bravo M, Shaz BH, Kamel H, Vanderpool S, Tomasulo P, Custer B, Townsend M. Detection of bacterial contamination in apheresis platelets: is apheresis technology a factor? Transfusion 2015; 55:2113-22. [DOI: 10.1111/trf.13107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/20/2015] [Accepted: 02/20/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | - Brian Custer
- Blood Systems Research Institute
- University of California at San Francisco; San Francisco California
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10
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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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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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12
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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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13
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Störmer M, Wood EM, Schurig U, Karo O, Spreitzer I, McDonald CP, Montag T. Bacterial safety of cell-based therapeutic preparations, focusing on haematopoietic progenitor cells. Vox Sang 2013; 106:285-96. [PMID: 24697216 DOI: 10.1111/vox.12097] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 02/14/2013] [Accepted: 09/03/2013] [Indexed: 11/28/2022]
Abstract
Bacterial safety of cellular preparations, especially haematopoietic progenitor cells (HPCs), as well as advanced therapy medicinal products (ATMPs) derived from stem cells of various origins, present a challenge for physicians, manufacturers and regulators. The article describes the background and practical issues in this area and illustrates why sterility of these products cannot currently be guaranteed. Advantages and limitations of approaches both for classical sterility testing and for microbiological control using automated culture systems are discussed. The review considers novel approaches for growth-based rapid microbiological control with high sensitivity and faster availability of results, as well as new methods for rapid bacterial detection in cellular preparations enabling meaningful information about product contamination within one to two hours. Generally, however, these direct rapid methods are less sensitive and have greater sampling error compared with the growth-based methods. Opportunities for pyrogen testing of cell therapeutics are also discussed. There is an urgent need for development of novel principles and methods applicable to bacterial safety of cellular therapeutics. We also need a major shift in approach from the traditional view of sterility evaluation (identify anything and everything) to a new thinking about how to find what is clinically relevant within the time frame available for the special clinical circumstances in which these products are used. The review concludes with recommendations for optimization of microbiological control of cellular preparations, focusing on HPCs.
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Affiliation(s)
- M Störmer
- Department of Transfusion Medicine, University of Cologne, Cologne, Germany; Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
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14
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Clark P, Trickett A, Chimenti M, Stark D. Optimization of microbial screening for cord blood. Transfusion 2013; 54:550-9. [PMID: 23889674 DOI: 10.1111/trf.12352] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/05/2013] [Accepted: 06/11/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Collection and processing of cord blood (CB) is associated with significant risk of contamination; hence standards mandate microbial screening of the final product. The sensitivity of current methods to evaluate the microbial content of CB is unknown, given the small volume tested and reduced sensitivity of pediatric bottles. Hence, this study was undertaken to evaluate an optimal microbial screening method. STUDY DESIGN AND METHODS CB was collected using a closed system then spiked with organisms at 1 or 10 colony-forming units (CFUs)/mL. Samples were screened using culture bottles (BacT/ALERT, bioMérieux; and BACTEC, Becton Dickinson). Several methods were evaluated with different combinations of inoculated bottles (adult vs. pediatric), sample types (plasma discard, red blood cell [RBC] discard, or final product), and sample volumes. RESULTS Of 94 cord blood units (CBUs) spiked with organisms before screening, 81% tested positive for contamination overall. Screening of CB in pediatric bottles resulted in equivalent detection rates on the BacT/ALERT and BACTEC systems (33% at 1 CFU/mL and 73% at 10 CFUs/mL, respectively). However, the pediatric bottle screen only detected 15% of obligate anaerobes. A combined fraction method showed superior detection (71%) compared to the plasma fraction (27%) and resulted in optimal anaerobic detection. CONCLUSIONS This study demonstrates that the optimal microbial screening method for CB includes testing a combination of discard fractions (plasma and RBCs) in addition to final product using an automated culture system. Inoculating a small sample of final product in a pediatric bottle is suboptimal for microbial detection and may lead to distribution of contaminated CB for transplantation.
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Affiliation(s)
- Pamela Clark
- Sydney Cord Blood Bank, Sydney Children's Hospital, Randwick, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
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15
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Choi SK, Myc A, Silpe JE, Sumit M, Wong PT, McCarthy K, Desai AM, Thomas TP, Kotlyar A, Holl MMB, Orr BG, Baker JR. Dendrimer-based multivalent vancomycin nanoplatform for targeting the drug-resistant bacterial surface. ACS NANO 2013; 7:214-228. [PMID: 23259666 DOI: 10.1021/nn3038995] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Vancomycin represents the preferred ligand for bacteria-targeting nanosystems. However, it is inefficient for emerging vancomycin-resistant species because of its poor affinity to the reprogrammed cell wall structure. This study demonstrates the use of a multivalent strategy as an effective way for overcoming such an affinity limitation in bacteria targeting. We designed a series of fifth generation (G5) poly(amidoamine) (PAMAM) dendrimers tethered with vancomycin at the C-terminus at different valencies. We performed surface plasmon resonance (SPR) studies to determine their binding avidity to two cell wall models, each made with either a vancomycin-susceptible (D)-Ala-(D)-Ala or vancomycin-resistant (D)-Ala-(D)-Lac cell wall precursor. These conjugates showed remarkable enhancement in avidity in the cell wall models tested, including the vancomycin-resistant model, which had an increase in avidity of four to five orders of magnitude greater than free vancomycin. The tight adsorption of the conjugate to the model surface corresponded with its ability to bind vancomycin-susceptible Staphylococcus aureus bacterial cells in vitro as imaged by confocal fluorescent microscopy. This vancomycin platform was then used to fabricate the surface of iron oxide nanoparticles by coating them with the dendrimer conjugates, and the resulting dendrimer-covered magnetic nanoparticles were demonstrated to rapidly sequester bacterial cells. In summary, this article investigates the biophysical basis of the tight, multivalent association of dendrimer-based vancomycin conjugates to the bacterial cell wall, and proposes a potential new use of this nanoplatform in targeting Gram-positive bacteria.
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Affiliation(s)
- Seok Ki Choi
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Berger K, Bauer M, Schopohl D, Henschler R, Ostermann H. Model Calculations to Quantify Clinical and Economic Effects of Pathogen Inactivation in Platelet Concentrates. ACTA ACUST UNITED AC 2013; 36:53-9. [DOI: 10.1159/000346309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Walther-Wenke G, Schmidt M. Impact of Bacterial Contamination on Blood Supply. Transfus Med Hemother 2011; 38:229-230. [PMID: 22016690 PMCID: PMC3190216 DOI: 10.1159/000330431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Gabriele Walther-Wenke
- Centre for Transfusion Medicine, German Red Cross Blood Donation Service West, Münster, Johann Wolfgang Goethe University, Frankfurt/M., Germany
| | - Michael Schmidt
- German Red Cross, Institute for Transfusion Medicine and Immunohaematology, Johann Wolfgang Goethe University, Frankfurt/M., Germany
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