Operational feasibility of routine bacterial monitoring of platelets

Macauley, A.; Chandrasekar, Anjalakshi; Geddis, G.; Morris, K.; McClelland, W. M.

doi:10.1046/j.1365-3148.2003.00441.x

Cited by 39 publications

(57 citation statements)

References 7 publications

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“…UK haemovigilance data for the period 1996-2001 show that of 38 transfusion-transmitted infections, 21 were caused by bacteria (17 associated with platelet components), six of which were fatal [23]. Routine bacterial testing of all platelet units before release would be a possibility to avoid such side effects but may require extension of shelf life if unacceptable wastage is to be avoided [24,25].…”

Section: Discussionmentioning

confidence: 99%

In vitro evaluation of COM.TEC apheresis platelet concentrates using a preparation set and pathogen inactivation over a storage period of five days

Moog¹,

Frohlich²,

Mayaudon

et al. 2004

J of Clinical Apheresis

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The aim of the present study was to evaluate in vitro data on platelets collected by apheresis, processed on a preparation set followed by photochemical treatment (PCT). Fifteen single-donor platelet concentrates (PCs) were collected by apheresis (COM.TEC blood cell separator, Fresenius, Bad Homburg, Germany). The platelets were transferred to the preparation set and plasma was removed after centrifugation to resuspend the platelets in approximately 37% plasma and 63% platelet additive solution InterSol. PCT was done by exposing the platelets to amotosalen HCl followed by illumination with ultraviolet light. Blood cell counts and in vitro PLT function were measured up to 5 days. An average of 3.44 +/- 0.28 x 10(11) platelets were collected in a product volume of 351 +/- 21 mL. Plasma removal resulted in a mean platelet loss of 7.8%. After PCT, a progressive decrease in platelet function was observed. LDH level rose through storage (171 +/- 81 U/L) to levels approximating LDH levels observed post-collection (180 +/- 103 U/L). There was a gradual decrease of the platelets to respond to hypotonic shock response from 90 +/- 9 % post-plasma reduction to 48 +/- 16% at day 5. All PLT units met the European requirements for leukoreduction and the pH limit of 6.8 up to day 5 post-collection. The new preparation set was capable of producing platelet units meeting the requirements for PCT. Despite differences observed in in vitro platelet function parameters, PLTs at storage day 5 fit the German and European guidelines.

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Section: Discussionmentioning

confidence: 99%

In vitro evaluation of COM.TEC apheresis platelet concentrates using a preparation set and pathogen inactivation over a storage period of five days

Moog¹,

Frohlich²,

Mayaudon

et al. 2004

J of Clinical Apheresis

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“…Even with a visual reference, the method has been described as biased, inaccurate, and misleading (12). Automated culture systems which were developed for testing whole blood samples in hospital settings (9,20) and are used for platelet concentrate screening (8,17,21) have not yet been developed for routine RBCC screening.…”

Section: Discussionmentioning

confidence: 99%

Detection of Bacteria in Red Blood Cell Concentrates by the Scansystem Method

Ribault¹,

Faucon²,

Grave³

et al. 2005

J Clin Microbiol

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Bacterial contamination remains one of the major risks associated with blood product transfusion. The kinetics of bacterial growth in red blood cell concentrates (RBCC) is different than otherwise due to storage at 4°C, conditions in which most bacteria do not survive. Psychrophilic bacteria such as Yersinia enterocolitica, however, can proliferate from a very low level of contamination to clinically significant levels at 4°C and are known to cause severe transfusion-related infections. A screening method allowing the early detection of very low levels of bacteria in RBCC would improve transfusion safety. The Scansystem method has been previously described for detection of bacteria in platelet concentrates. We present here a modification of the system for detection of low levels of bacteria in RBCC. The Scansystem RBC kit protocol requires three steps, i.e., the agglutination and selective removal of RBCs, a labeling stage during which bacteria are labeled with a DNA-specific fluorophore, and finally recovery of bacteria on the surface of a black membrane for analysis using the Scansystem. The entire procedure from sampling to result can be completed in 90 min. Both gram-negative and gram-positive bacteria in RBCC are detected with a higher sensitivity than with currently available culture-based methods. The Scansystem RBC kit is shown to be sensitive enough to identify low-level bacterial contamination in a single unit tested in a pool of up to 20 RBCC samples (detection limit of between 1 and 10 CFU/ml depending on the bacterial strain). The method therefore lends itself to incorporation into high-sample-throughput screening programs.Due to the availability of highly sensitive virus screening kits, in donated blood products bacterial contamination, now the greatest risk for patients receiving a transfusion, is found 50 to 250 times more frequently than viral infection such as human immunodeficiency virus, hepatitis virus, or human T-cell lymphotropic virus infection. Transfusion-related bacterial infections are usually associated with a rapid onset of sepsis with high mortality rates (4, 16). Platelet concentrate preparations are known to carry a greater risk of bacterial infections, as they are required to be stored at 20 to 24°C (3, 6, 7, 10). With the significantly higher number of red blood cell concentrates (RBCC) transfused, however, the incidence of transfusionassociated bacterial contamination is similar (5,11,18,28). In the French Bacthem case-control study, 41 bacterium-related transfusion reactions were reported during a 2-year period, including 25 following transfusion with RBCC, with 4 fatalities, and 16 following platelet transfusion, with 2 fatalities (23).Currently, the examination of the RBCC bag for evidence of hemolysis just prior to transfusion is the only screening method carried out to check for bacterial contamination (12). However, visual inspection is subjective, and hemolysis also occurs in noncontaminated units nearing the end of their shelf life. Identification of low levels of bact...

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“…The BacT/Alert system has also been used for applications that require high sensitivity and rapid turn-around time, such as the culture of peritoneal dialysate, synovial and amniotic fluids, 9 as well as platelets. 10 Non-clinical applications include sterility testing of foods (bioMérieux, USA).…”

Section: Discussionmentioning

confidence: 99%