Antibiotic‐labeled probes and microvolume fluorimetry for the rapid detection of bacterial contamination in platelet components: a preliminary report

Brecher, Mark E.; Wong, E.C.C.; Chen, S.E.; Vampola, Christine; Rocco, Richard M.

doi:10.1046/j.1537-2995.2000.40040411.x

Cited by 16 publications

(11 citation statements)

References 20 publications

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“…Tests with bacteria-specific nucleic acid probes or fluorescent dyes or antibodies are currently being developed. 70,71 However, the most useful detection systems currently available appear to be automated, culture-based methods similar to what has been used for clinical detection of bacteremia in blood cultures obtained from patients.…”

Section: Detection Of Bacteria In Transfusion Productsmentioning

confidence: 99%

Bacterial Contamination of Blood Components: Risks, Strategies, and Regulation

Hillyer

Josephson²,

Blajchman³

et al. 2003

Hematology

221

210

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Bacterial contamination of transfusion products, especially platelets, is a longstanding problem that has been partially controlled through modern phlebotomy practices, refrigeration of red cells, freezing of plasma and improved materials for transfusion product collection and storage. Bacterial contamination of platelet products has been acknowledged as the most frequent infectious risk from transfusion occurring in approximately 1 of 2,000-3,000 whole-blood derived, random donor platelets, and apheresis-derived, single donor platelets. In the US, bacterial contamination is considered the second most common cause of death overall from transfusion (after clerical errors) with mortality rates ranging from 1:20,000 to 1:85,000 donor exposures. Estimates of severe morbidity and mortality range from 100 to 150 transfused individuals each year.Concern This Joint ASH and AABB Educational Session reviews the risks, testing strategies, and regulatory approaches regarding bacterial contamination of blood components to aid in preparing practitioners of hematology and transfusion medicine in understanding the background and clinical relevance of this clinically important issue and in considering the approaches currently available for its mitigation, as well as their implementation.In this chapter, Drs. Hillyer and Josephson review the background and significance of bacterial contamination, as well as address the definitions, conceptions and limitations of the terms risk, safe and safety. They then describe current transfusion risks including non-infectious serious hazards of transfusion, and current and emerging viral risks. In the body of the text, Dr. Blajchman reviews the prevalence of bacterial contamination in cellular blood components in detail with current references to a variety of important studies. He then describes the signs and symptoms of transfusion-associated sepsis and the sources of the bacterial contamination for cellular blood products including donor bacteremia, and contamination during whole blood collection and of the collection pack. This is followed by strategies to decrease the transfusion-associated morbidity/mortality risk of contaminated cellular blood products 576American Society of Hematology including improving donor skin disinfection, removal of first aliquot of donor blood, pretransfusion detection of bacteria, reducing recipient exposure, and pathogen reduction/inactivation. In the final sections, Drs. Vostal, Epstein and Goodman describe the regulations and regulatory approaches critical to the appropriate implementation of a bacterial contamination screening and limitation program including their and/or the FDA's input on prevention of bacterial contamination, bacterial proliferation, and detection of bacteria in transfusion products. This is followed by a discussion of sampling strategy for detection of bacteria in a transfusion product, as well as the current approval process for bacterial detection devices, trials recommended under "actual clinical use" conditions, pathogen reduction ...

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Section: Detection Of Bacteria In Transfusion Productsmentioning

confidence: 99%

Bacterial Contamination of Blood Components: Risks, Strategies, and Regulation

Hillyer

Josephson²,

Blajchman³

et al. 2003

Hematology

221

210

View full text Add to dashboard Cite

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“…Antibiotics are available in large concentrations and are inexpensive in comparison to monoclonal antibodies. In a preliminary report,¯u-orescent-labeled vancomycin was used to detect contamination of platelets with Staphylococcus epidermidis at levels of 2´10 5 CFU/mL [66].…”

Section: Microvolume Fluorimetrymentioning

confidence: 99%

Bacterial contamination of blood products: Factors, options, and insights

Depcik‐Smith

Hay

Brecher

2001

J of Clinical Apheresis

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Transfusion of bacterially contaminated blood products remains an overlooked problem. However, the risk of receiving a bacterially contaminated unit is greater than the combined risk of HIV-1/2, HCV, HBV, and HTLV I/II [American Association of Blood Banks Bulletin, no. 294, 1996]. Topics covered in this article include: the current incidence, clinical presentation and outcome, effective methods of detection, and ways to reduce bacterial contamination of blood products. There is no one existing strategy that can completely eliminate the risk of bacterial contamination. It is inevitable that partial solutions or combinations of methods will be implemented in the near future.

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“…40 More sensitive methods, such as ribosomal RNA probes based on detection of highly conserved regions of bacterial ribosomal RNA-labeled antibiotic probes that capitalize on the capacity of antibiotics to bind specific bacteria and microscopy with acridine orange staining, become feasible with inoculum exceeding 10 5 CFU/ mL, but they may take up to day 4 of storage to attain this level. 41,42 Of course, the most sensitive methods are the bacteriologic gold standard of sterility-culture (automated liquid-based systems can reliably detect as few as 10 CFU/mL 43 ) and the newer and more rapid molecular technique, real-time polymerase chain reaction (enabling detection of 50 CFU/mL within 4 hours 44,45 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of Bacterial Detection in Whole Blood–Derived Platelets by Quantitative Glucose Testing at a University Medical Center

McKane

Ward

Senn

et al. 2009

American Journal of Clinical Pathology

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After the March 2004 implementation of American Association of Blood Banks standards regarding platelet bacterial detection, we began quantitative glucose screening of whole blood-derived platelets (WB-P). The glucose level was measured immediately before component release--often storage day 4 or 5--using the Glucometer SureStep Flexx Meter (LifeScan, Milpitas, CA), with a positive cutoff of less than 500 mg/dL; failing units were cultured and not transfused. During 29 months (March 1, 2004-July 31, 2006) 93,073 units of WB-P were tested. Initially, 929 units (0.998%) screened positively. Bacterial growth was culture-confirmed in 6 units, for a bacterial contamination incidence of 0.006% and a true-positive rate of 6.4/100,000. Three additional culture-confirmed contamination cases were detected in transfused units causing febrile nonhemolytic reactions, for a false-negative rate of 3.2/100,000. Our overall contamination prevalence was 9.6/100,000 units of platelets transfused, lower than ordinarily cited, and showed a false-negative rate remarkably congruent to that of culture: 3.2/100,000. A low-sensitivity screening test applied late in platelet shelf-life can be comparable to culture in preventing bacterial-related morbidity.

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Antibiotic‐labeled probes and microvolume fluorimetry for the rapid detection of bacterial contamination in platelet components: a preliminary report

Cited by 16 publications

References 20 publications

Bacterial Contamination of Blood Components: Risks, Strategies, and Regulation

Bacterial Contamination of Blood Components: Risks, Strategies, and Regulation

Bacterial contamination of blood products: Factors, options, and insights

Analysis of Bacterial Detection in Whole Blood–Derived Platelets by Quantitative Glucose Testing at a University Medical Center

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