Chloramphenicol antibody causing interference in antibody detection and identification tests

Abstract

Investigation of the serum of three patients with positive antibody detection tests demonstrated the cause in each to be an antibody against chloramphenicol, a bacteriostatic agent used in commercial red blood cell reagents. Washing of these red cells prior to use prevented agglutination. All three examples of anti-chloramphenicol antibody were IgM and were in low titer when tested at room temperature and 37 C in saline. Two of the antibodies bound complement. The possibility of an antibody to an ingredient of the commercial preservative solution should be considered if problems are encountered in tests with unwashed commercial red blood cell reagents.

11-Oxycorticosteroid-Dependent Antibody in the Serum of a Patient with Bladder Neoplasm

“…Pan agglutination at 4-37°C, titer 128, score 74, without recog nizable blood group specificity and negative autologous control were observed using the panel of reagent RBCs A, while anti-I at 4°C, titer 16, score 51 was found using pan els of reagent RBCs B and C. The DAT test was negative. One of the least frequent causes of positive pretrans fusion tests is the presence in the patient's serum of anti bodies against chloramphenicol [5], neomycin [6], tetra cycline [3], hydrocortisone [7], which are often used as preservatives in the preparation of reagent RBCs. It may also be produced by alloantibodies or autoantibodies whose detection requires the presence of drugs, such as caprylate (autoanti-e) [8], borate (anti-A) [9],chloram phenicol (anti-Ai) [10], paraben (autoanti-Jk"') [11], thimerosal (IgG autoantibody) [12], sodium azide (anti-I) [13], LISS (anti-Pr,) [14], Drug-dependent antibodies without apparent group specificity have also been described [15], and some antidrug antibodies may adhere to the RBC surface by means of the Matuhasi-Ogata phenomenon yes ves ves yes yes ves…”

In vitro reactions with red blood cells that are not due to blood group antibodies: a review

“…Most media contain chloramphenicol and neomycin sulfate, but some manufacturers add gentamicin, tetracycline, or streptomycin. Antibodies to any of these antibiotics can be present in a patient's serum, 2 but only antibodies to neomycin, 3 chloramphenicol, [4][5][6] In vitro reactions with red blood cells that are not due to blood group antibodies: a review G. GARRATTY and gentamicin 7 have been described, so far, as causing a problem with blood typing.…”

“…In contrast, neomycin, chloramphenicol, and gentamicin do not seem to bond covalently to RBC membranes and are easily washed away. The reports of ABO grouping problems due to these antibiotics [3][4][5][6][7] suggest that the in vitro reactions parallel those described for the drugs reacting by the so-called "immune complex" mechanism. 2,8,9 That is to say, the reactions are seen only when the patient's serum, containing the antibody, is added to RBCs in the presence of the antibiotic (i.e., in the commercial RBC suspension medium).…”

Detection of antibodies to co-trimoxazole (preservative drug) interfering with routine red cell antibody screening

“…[ 1 ] Various manufacturers add antibiotics to the red cell suspension media. Antibodies to chloramphenicol,[ 2 ] neomycin sulfate,[ 3 ] gentamicin,[ 4 ] etc., have been reported. We present here a rare case of anti-co-trimoxazole drug-induced antibody detected during routine antibody screening.…”