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Gravemann U, Handke W, Schulze TJ, Seltsam A. Growth and Distribution of Bacteria in Contaminated Whole Blood and Derived Blood Components. Transfus Med Hemother 2024; 51:76-83. [PMID: 38584696 PMCID: PMC10996057 DOI: 10.1159/000536242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 01/10/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Bacterial contamination of blood products presumably occurs mainly during blood collection, starting from low initial concentrations of 10-100 colony-forming units (CFUs) per bag. As little is known about bacterial growth behavior and distribution in stored whole blood (WB) and WB-derived blood products, this study aims to provide data on this subject. Methods WB units were inoculated with transfusion-relevant bacterial species (Acinetobacter baumannii, Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Pseudomonas fluorescens, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus dysgalactiae, Streptococcus pyogenes, Yersinia enterocolitica; n = 12 for each species), stored for 22-24 h at room temperature, and then centrifuged for separation into plasma, red blood cells (RBCs), and buffy coats (BCs). The latter were pooled with 3 random donor BCs and one unit of PAS-E each to yield plasma-reduced platelet concentrates (PCs). Samples for bacterial colony counting were collected after WB storage and immediately after blood component production. Sterility testing in PCs (n = 12 for each species) was performed by bacterial culture after 7 days of storage. Results Bacterial growth in WB varied remarkably between donations and species. Streptococcus species produced the highest titers in WB, whereas Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas fluorescens did not multiply. Centrifugation resulted in preferential accumulation of bacteria in BCs, with titers of up to 3.5 × 103 CFU/mL in BCs and up to ≤0.9 × 103 CFU/mL in BC-derived PCs. Overall, 72/144 PCs (50%) tested positive for bacteria after storage. Sterility test results were species-dependent, ranging from 12 of 12 PCs tested positive for Streptococcus pyogenes to 1 of 12 PCs positive for Escherichia coli. Bacterial contamination of RBC and plasma units was much less common and was associated with higher initial bacterial counts in the parent WB units. Conclusions Bacterial growth in WB is species-dependent and varies greatly between donations. Preferential accumulation of bacteria in BCs during manufacturing is a critical determinant of the contamination risk of BC-derived pooled PCs.
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Affiliation(s)
- Ute Gravemann
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Wiebke Handke
- Bavarian Red Cross Blood Service, Institute Nuremberg, Nuremberg, Germany
| | - Torsten J. Schulze
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Axel Seltsam
- Bavarian Red Cross Blood Service, Institute Nuremberg, Nuremberg, Germany
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2
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Vollmer T, Knabbe C, Dreier J. Dual-Temperature Microbiological Control of Cellular Products: A Potential Impact for Bacterial Screening of Platelet Concentrates? Microorganisms 2023; 11:2350. [PMID: 37764194 PMCID: PMC10534585 DOI: 10.3390/microorganisms11092350] [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: 08/09/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
An experimental study by the Paul-Ehrlich Institute (PEI) demonstrated that temperatures between 35 and 37 °C are too high for the growth of some bacterial strains (e.g., Pseudomonas fluorescens), leading to false negative results. Thus, the question of whether it is necessary to adapt incubation temperatures for the microbiological control of blood products, especially platelet concentrates (PCs), to enhance safety and regulatory compliance has arisen. In order to further elucidate this issue, the growth capability of different bacterial strains of interest in PCs and the detection efficacy of cultivation of these at different incubation temperatures must be taken into account. Therefore, we inoculated PCs with 46 different strains (3-6 PCs from different donors per strain) from different origins (PC isolates, reference strains) and stored PCs at 20-22 °C under constant agitation. On day three of storage, the inoculated PCs were sampled; aerobic and anaerobic culture bottles (BacT/Alert AST/NST) were each inoculated with 5 mL of sample, and culture bottles were incubated at 25 and 35 °C using the automated BacT/Alert Dual-temperature system. Bacterial proliferation was enumerated using a colony-forming assay. All strains of Enterobacteriacae (n = 5), Staphy-lococcus spp. (n = 11), Streptococcus spp. (n = 5), and Bacillus spp. (n = 4) and most Pseudomonas aeruginosa strains (4 of 5) tested showed the capability to grow in most inoculated PCs, revealing a faster time to detection (TTD) at an incubation temperature of 35 °C. The tested Pseudomonas putida (n = 3) strains showed a noticeably reduced capability to grow in PCs. Nonetheless, those with a notable growth capability revealed a faster TTD at an incubation temperature of 35 °C. Only one of the four Pseudomonas fluorescens strains tested (strain ATCC 13525) was able to grow in PCs, showing a faster TTD at an incubation temperature of 25 °C but also detection at 35 °C. The commonly detected bacteria involved in the bacterial contamination of PCs showed a superior TTD at 35 °C incubation. Only one P. fluorescens strain showed superior growth at 25 °C; however, the microbiological control at 35 °C did not fail to identify this contamination. In conclusion, the use of PC screening using a dual-temperature setting for microbiological control is presently not justified according to the observed kinetics.
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Affiliation(s)
- Tanja Vollmer
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
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3
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Cloutier M, De Korte D. Residual risks of bacterial contamination for
pathogen‐reduced
platelet components. Vox Sang 2022; 117:879-886. [DOI: 10.1111/vox.13272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/22/2021] [Accepted: 02/10/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Marc Cloutier
- Medical Affairs and Innovation Héma‐Québec Québec Canada
- Biochemistry, Microbiology and Bio‐informatics Université Laval Québec Canada
| | - Dirk De Korte
- Blood Cell Research Sanquin Research Amsterdam The Netherlands
- Product and Process Development Sanquin Blood Bank Amsterdam The Netherlands
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Ranade H, Paliwal P, Pal D, Datta M. Honey-based trap for Pseudomonas: a sustainable prototype for water disinfection. Arch Microbiol 2021; 203:6061-6069. [PMID: 34546384 DOI: 10.1007/s00203-021-02568-0] [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: 07/11/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
This paper introduces a novel prototype for the removal of Pseudomonas from water samples. Bacterial cells have the tendency to get attracted towards specific chemicals (chemotaxis); a 'honey-based trap' (henceforth, addressed as 'honey-trap') strip was conceptualized by integrating a combination of serine, pseudomonas-specific chemoattractant and honey to attract and inhibit the bacteria in situ. Honey, a natural antimicrobial agent, has garnered the attention as an effective inhibitor for Pseudomonal biofilms and wound infections. Dipping serine side of the strip attracted bacteria towards honey-trap, whereby the porous nature of the strip facilitated the 'trapping' and subsequent diffusion of the bacterial cells towards honey-adsorbed end of the strip. This 'honey-trap' reportedly leads to the targeted elimination of Pseudomonas, hence facilitating its removal. The percentage efficacy of this 'honey-trap' device is 96% with a log reduction equivalent to 1.6 within a time frame of 2 h. Pseudomonas aeruginosa, although, not a natural contaminant of potable water, enters circulation due to improperly maintained plumbing fixtures and storage facilities. Honey-trap strip is an easy to use, biodegradable and cost-effective sustainable solution, and thus a scaled-up version of this device may enable substantial improvement in quality of potable water. Schematics showing the preparation and working of the Pseudomonas Honey-trap. Serine as an attractant and honey as an inhibitor was absorbed on filter strips (HT) for use. The strip was dipped in culture from serine end. After different time period of incubation, difference in bacterial load was confirmed by measuring the electrical conductivity and OD600nm of the culture. Additionally, inhibitory effect of HS was confirmed by placing the strip incubated with culture on agar plates and differences in bacterial lawn were monitored. Removal of bacterial cells from the suspension was also confirmed using absorption spectroscopy.
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Affiliation(s)
- Hemangi Ranade
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303007, India
| | - Priya Paliwal
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303007, India
| | - Debarati Pal
- Amity Institute of Biotechnology, Amity University, Sec 125, Noida, 201311, India
| | - Manali Datta
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303007, India.
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5
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Alabdullatif M, Osman IE, Alrasheed M, Ramirez-Arcos S, Alyousef M, Althawadi S, Alhumiadan H. Evaluation of riboflavin and ultraviolet light treatment against Klebsiella pneumoniae in whole blood-derived platelets: A pilot study. Transfusion 2021; 61:1562-1569. [PMID: 33687079 DOI: 10.1111/trf.16347] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/27/2020] [Accepted: 12/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bacterial contamination of platelet concentrates (PCs) is the predominant cause of infectious transfusion reactions. The Pathogen Inactivation Mirasol system was implemented at the King Faisal Specialist Hospital (Saudi Arabia) to reduce the risk of transfusing contaminated PCs. This pilot study evaluated the effectiveness of Mirasol against Klebsiella pneumoniae, a pathogen associated with transfusion reactions, in whole blood-derived PCs. STUDY DESIGN AND METHODS Whole blood (WB) units inoculated with one of six K. pneumoniae strains (five clinical isolates and ATCC-700603) at a concentration of 3-38 CFU/unit, were processed using the platelet-rich plasma (PRP) method. Each spiked PC was pooled with four unspiked units. The pooled PC was split into three Mirasol storage bags: an untreated unit (control), and two units treated with Mirasol at 26 and 32 h post-WB collection, respectively. PC samples obtained before and after Mirasol treatment were used for BacT/ALERT cultures and determination of bacteria quantification. Each experiment was repeated three independent times. RESULTS Five strains were detected prior to PC treatment (24 h post-WB spiking), while one clinical isolate was not detected. Mirasol treatment after 26 h of WB collection resulted in complete inactivation of all K. pneumoniae strains. However, treatment 32 h post-WB collection resulted in the breakthrough of one clinical isolate in two of the three replicates with ~7.8 log10 CFU/unit detected on day 5 of PC storage. CONCLUSION Delayed Mirasol treatment from 26 to 32 h post-WB collection, resulted in one breakthrough. These results highlight the importance of minimizing the time between WB collection and PI treatment.
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Affiliation(s)
- Meshari Alabdullatif
- Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.,Department of Microbiology, SmartLab, Riyadh, Saudi Arabia
| | - Imad Eldin Osman
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mai Alrasheed
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Manal Alyousef
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sahar Althawadi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hind Alhumiadan
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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6
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Bacterial contamination of blood products for transfusion in the Democratic Republic of the Congo: temperature monitoring, qualitative and semi-quantitative culture. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 18:348-358. [PMID: 32931413 DOI: 10.2450/2020.0108-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Bacterial contamination of blood for transfusion is rarely investigated in low-income countries. We determined the contamination rate of blood products in the Democratic Republic of the Congo. MATERIAL AND METHODS In this prospective observational study, blood products in one rural and two urban hospitals (paediatric and general) contained a satellite sampling bag by which blood was sampled for culture in a blood culture bottle (4 mL) and on an agar-coated slide to estimate colony forming units (CFU/mL). Bacteria were identified with biochemical tests and MALDI-TOF (Bruker). Exposure time >10 °C was assessed on a subset of blood products. RESULTS In total, 1.4% (41 of 2,959) of blood products were contaminated with 48 bacterial isolates. Skin (e.g., Staphylococcus spp.) and environmental (e.g., Bacillus spp.) bacteria predominated (97.8% of 45 isolates identified). Bacterial counts were ≤103 CFU/mL. Contamination rates for the urban paediatric, urban general and rural hospitals were 1.6%, 2.4% and 0.3%, respectively (p=0.004). None of the following variables was significantly associated with contamination: (i) donor type (voluntary 1.6%, family 1.2%, paid 3.9%); (ii) type of blood product (red cells 1.6%, whole blood 0.6%); (ii) season (dry season 2.4%, rainy season 1.8%); (iv) age of blood product (contaminated 8 days vs non-contaminated 6 days); and (v) exposure time >10 °C (median for contaminated and non-contaminated blood reached maximum test limit of 8 hours). DISCUSSION A bacterial contamination rate of 1.4% of whole blood and red cells is similar to results from high-income countries. Implementation of feasible risk-mitigation measures is needed.
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7
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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: 8] [Impact Index Per Article: 1.6] [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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8
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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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9
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Kim S, Handke W, Gravemann U, Döscher A, Brixner V, Müller TH, Seltsam A. Mitochondrial DNA multiplex real-time polymerase chain reaction inhibition assay for quality control of pathogen inactivation by ultraviolet C light in platelet concentrates. Transfusion 2017; 58:758-765. [PMID: 29282743 DOI: 10.1111/trf.14464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several ultraviolet (UV) light-based pathogen inactivation (PI) technologies for platelet (PLT) products have been developed or are under development. Upon implementation of PI technologies, quality control measures are required to ensure consistent efficiency of the treatment process. Previous reports showed that amotosalen/UVA and riboflavin/UV-based PI technologies induce modifications of the PLT-derived mitochondrial DNA (mtDNA) that can be detected by polymerase chain reaction (PCR) inhibition assays. In this study, we sought to establish a PCR inhibition assay to document the impact of ultraviolet C (UVC) treatment with the THERAFLEX UV-Platelets system on the mitochondrial genome in PLT concentrates (PCs). STUDY DESIGN AND METHODS A multiplex real-time PCR inhibition assay with simultaneous short-amplicon (143 bp) and long-amplicon (794 bp) amplification was developed to detect mtDNA modifications in PLTs after UVC treatment. Assay performance was tested in UVC-treated and untreated, plasma-reduced pooled PCs, and apheresis PCs and challenged using PCs manufactured for a clinical trial under routine-like conditions. RESULTS UVC illumination of PLTs resulted in dose-dependent inhibition of mtDNA amplification for the larger amplicon. Amplification of the shorter amplicon was not affected by UVC treatment. Evaluation of 283 blinded apheresis and pooled PLT samples from routine-like PC production resulted in prediction of UVC treatment status with 100% accuracy. CONCLUSION The proposed dual-amplicon size real-time mtDNA PCR assay effectively detects nucleic acid damage induced by UVC illumination of PLTs and could be useful as an informative indicator of PI quality of the THERAFLEX UV-Platelets system.
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Affiliation(s)
- Sinyoung Kim
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany.,Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Wiebke Handke
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Andrea Döscher
- German Red Cross Blood Service NSTOB, Institute Oldenburg-Bremen, Oldenburg, Germany
| | - Veronika Brixner
- German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt, Germany
| | - Thomas H Müller
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
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10
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Kreuger AL, Rostgaard K, Middelburg RA, Kerkhoffs JLH, Edgren G, Erikstrup C, Pedersen OB, Titlestad K, Nielsen KR, Ostrowski SR, Voldstedlund M, van der Bom JG, Ullum H, Hjalgrim H. Storage time of platelet concentrates and risk of a positive blood culture: a nationwide cohort study. Transfusion 2017; 58:16-24. [PMID: 29168187 DOI: 10.1111/trf.14401] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Concern of transfusion-transmitted bacterial infections has been the major hurdle to extend shelf life of platelet (PLT) concentrates. We aimed to investigate the association between storage time and risk of positive blood cultures at different times after transfusion. STUDY DESIGN AND METHODS We performed a nationwide cohort study among PLT transfusion recipients in Denmark between 2010 and 2012, as recorded in the Scandinavian Donations and Transfusions (SCANDAT2) database. Linking with a nationwide database on blood cultures (MiBa), we compared the incidence of a positive blood culture among recipients of PLTs stored 6 to 7 days (old) to those receiving fresh PLTs (1-5 days), using Poisson regression models. We considered cumulative exposures in windows of 1, 3, 5, and 7 days. RESULTS A total of 9776 patients received 66,101 PLT transfusions. The incidence rate ratio (IRR) of a positive blood culture the day after transfusion of at least one old PLT concentrate was 0.77 (95% confidence interval [CI], 0.54-1.09) compared to transfusion of fresh PLT concentrates. The incidence rate of a positive blood culture was lower the day after receiving one old compared to one fresh PLT concentrate (IRR, 0.57; 95% CI, 0.37-0.87). Three, 5, or 7 days after transfusion, storage time was not associated with the risk of a positive blood culture. CONCLUSION Storage of buffy coat-derived PLT concentrates in PAS-C up to 7 days seems safe regarding the risk of a positive blood culture. If anything, transfusion of a single old PLT concentrate may decrease this risk the following day.
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Affiliation(s)
- Aukje L Kreuger
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Rutger A Middelburg
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jean-Louis H Kerkhoffs
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Haga Hospital, Den Haag, the Netherlands
| | - Gustav Edgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - Kjell Titlestad
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, the Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Marianne Voldstedlund
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - Johanna G van der Bom
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Henrik Ullum
- Department of Clinical Immunology, the Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
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11
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Kreuger AL, Middelburg RA, Kerkhoffs JLH, Schipperus MR, Wiersum-Osselton JC, van der Bom JG. Storage medium of platelet transfusions and the risk of transfusion-transmitted bacterial infections. Transfusion 2017; 57:657-660. [PMID: 28144957 DOI: 10.1111/trf.13969] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/13/2016] [Accepted: 11/08/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Transfusion-transmitted bacterial infections (TTBIs) are among the most concerning risks of transfusion of platelet (PLT) concentrates. Storage medium influences bacterial growth dynamics and thereby the sensitivity of screening tests for bacterial contamination. STUDY DESIGN AND METHODS The aim of this study was to quantify the association of storage media with the incidence of TTBIs after transfusion of PLT concentrates. In the Netherlands, the choice of storage medium is determined solely by geographic location of the hospital. We compared types of storage medium of all reported cases of TTBIs after transfusion of a PLT concentrate with types of storage medium of all produced PLT concentrates in the Netherlands from 2003 to 2014. RESULTS Fourteen cases of TTBIs were reported, of which 57.1% received a PLT concentrate stored in PLT additive solution (PAS) and 42.9% a PLT concentrate stored in plasma. Of all produced PLT concentrates 22.3% were stored in PAS and 77.7% in plasma. The relative risk of TTBI after transfusion of a PAS-stored PLT concentrate was 4.63 (95% confidence interval [CI], 1.4-16.2) compared to transfusion of a plasma-stored PLT concentrate. The incidence of TTBIs was 22.2 per million (95% CI, 12.1-37.2 per million) transfused buffy coat PLT concentrates. CONCLUSION Transfusion of PAS-stored PLT concentrates is associated with a fourfold increased incidence of TTBIs, compared to plasma-stored PLT concentrates.
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Affiliation(s)
- Aukje L Kreuger
- Center for Clinical Transfusion Research, Sanquin Research, Leiden University Medical Center, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rutger A Middelburg
- Center for Clinical Transfusion Research, Sanquin Research, Leiden University Medical Center, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jean-Louis H Kerkhoffs
- Center for Clinical Transfusion Research, Sanquin Research, Leiden University Medical Center, Leiden, the Netherlands.,Haga Hospital, Den Haag, the Netherlands
| | - Martin R Schipperus
- Haga Hospital, Den Haag, the Netherlands.,TRIP, Transfusion and Transplantation Reactions in Patients, Dutch National Hemovigilance Office, Leiden, the Netherlands
| | - Johanna C Wiersum-Osselton
- TRIP, Transfusion and Transplantation Reactions in Patients, Dutch National Hemovigilance Office, Leiden, the Netherlands
| | - Johanna G van der Bom
- Center for Clinical Transfusion Research, Sanquin Research, Leiden University Medical Center, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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12
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Bello-López JM, Ibáñez-Cervantes G, Fernández-Sánchez V, Arroyo-Pérez JA, Rojo-Medina J. Propagation capacity of bacterial contaminants in platelet concentrates using a luciferase reporter system. Transfus Apher Sci 2015; 52:326-31. [PMID: 25687788 DOI: 10.1016/j.transci.2015.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/23/2015] [Accepted: 01/27/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Currently the use of molecular tools and techniques of Genetic Engineering in the study of microbial behavior in blood components has replaced the employment of classical methods of microbiology. This work focuses on the use of a novel lux reporter system for monitoring the contaminating propagation capacity of bacteria present in platelet concentrates under standard storage conditions in the blood bank. METHODS A miniTn5 promotor probe carrying the lux operon from Photorhabdus luminiscens (pUTminiTn5luxCDABEKm2) was used to construct four bacterial bioluminescent mutants: Escherichia coli, Salmonella typhi, Proteus mirabilis and Pseudomonas aeruginosa. Luminescent mutants were used for contamination tests with 20 CFU in platelet concentrates bags and were stored under standard storage conditions in the blood bank (100 rpm at 22 °C). The measurements of luminous activity and optical density were used to monitor bacterial proliferation during 7 days (168 h). RESULTS During the exponential growth phase (log) of bacterial strains, a lineal correlation between luminous activity vs biomass was observed (R(2) = 0.985, 0.976, 0.981) for E. coli::Tn5luxCDABEKm2, P. mirabilis::Tn5luxCDABEKm2 and P. auriginosa::Tn5luxCDABEKm2, respectively. The above indicates that metabolic activity (production of ATP) is directly related to biomass in this phase of microbial growth. While conducting experiments, the inability to propagate S. typhi::Tn5luxCDABEKm2 was detected. We can speculate that platelet concentrates contain specific components that prevent the propagation of S. typhi. CONCLUSION The use of luxCDABE system for the quantification of luminous activity is a rapid and sensitive alternative to study the propagation and auto-sterilization of bacterial contaminants in platelet concentrates.
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Affiliation(s)
- Juan Manuel Bello-López
- Departamento de Investigación, Desarrollo y Control de Calidad, Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Col. Zacatenco, México D.F. C.P. 07360, Mexique
| | - Gabriela Ibáñez-Cervantes
- Departamento de Investigación, Desarrollo y Control de Calidad, Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Col. Zacatenco, México D.F. C.P. 07360, Mexique
| | - Verónica Fernández-Sánchez
- Departamento de Investigación, Desarrollo y Control de Calidad, Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Col. Zacatenco, México D.F. C.P. 07360, Mexique
| | - José Antonio Arroyo-Pérez
- Departamento de Investigación, Desarrollo y Control de Calidad, Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Col. Zacatenco, México D.F. C.P. 07360, Mexique
| | - Julieta Rojo-Medina
- Departamento de Investigación, Desarrollo y Control de Calidad, Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Col. Zacatenco, México D.F. C.P. 07360, Mexique.
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13
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Vollmer T, Knabbe C, Dreier J. Novel flow cytometric screening method for bacterial contamination of red blood cells: a proof-of-principle evaluation. Transfusion 2013; 54:900-9. [DOI: 10.1111/trf.12513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 10/19/2013] [Accepted: 10/20/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Tanja Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin; Herz- und Diabeteszentrum Nordrhein-Westfalen; Universitätsklinik der Ruhr-Universität Bochum; Bad Oeynhausen Germany
| | - Cornelius Knabbe
- Institut für Laboratoriums- und Transfusionsmedizin; Herz- und Diabeteszentrum Nordrhein-Westfalen; Universitätsklinik der Ruhr-Universität Bochum; Bad Oeynhausen Germany
| | - Jens Dreier
- Institut für Laboratoriums- und Transfusionsmedizin; Herz- und Diabeteszentrum Nordrhein-Westfalen; Universitätsklinik der Ruhr-Universität Bochum; Bad Oeynhausen Germany
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14
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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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