Efficiency of riboflavin and ultraviolet light treatment against high levels of biofilm‐derived <i>Staphylococcus epidermidis</i> in buffy coat platelet concentrates

Taha, Mariam; Culibrk, Brankica; Kaláb, Miloslav; Schubert, Peter; Yi, Qilong; Goodrich, Raymond P.; Ramirez‐Arcos, Sandra

doi:10.1111/vox.12519

Cited by 16 publications

(11 citation statements)

References 35 publications

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“…Longer growth periods may allow bacterial species such as S. epidermidis to adhere to the plastic walls of platelet containers and form biofilms during platelet storage . These biofilms may protect encapsulated bacteria from inactivation by reducing penetration of UV light or photochemicals, resulting in incomplete killing and further growth during subsequent storage . Bacterial biofilm formation is not relevant to the THERAFLEX UV‐Platelets procedure, which specifies that the platelets must be transferred to the illumination bag shortly before PI treatment.…”

Section: Discussionmentioning

confidence: 99%

Bacterial inactivation of platelet concentrates with the THERAFLEX UV‐Platelets pathogen inactivation system

et al. 2018

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BACKGROUND The THERAFLEX UV‐Platelets system (Maco Pharma) uses ultraviolet C (UVC) light for pathogen inactivation (PI) of platelet concentrates (PCs) without any additional photoactive compound. The aim of the study was to systematically investigate bacterial inactivation with this system under conditions of intended use. STUDY DESIGN AND METHODS The robustness of the system was evaluated by assessing its capacity to inactivate high concentrations of different bacterial species in accordance with World Health Organization guidelines. The optimal use of the PI system was explored in time‐to‐treatment experiments by testing its ability to sterilize PCs contaminated with low levels of bacteria on the day of manufacture (target concentration, 100 colony‐forming units/unit). The bacteria panel used for spiking experiments in this study included the World Health Organization International Repository Platelet Transfusion Relevant Reference Strains (n = 14), commercially available strains (n = 13), and in‐house clinical isolates (n = 2). RESULTS Mean log reduction factors after UVC treatment ranged from 3.1 to 7.5 and varied between different strains of the same species. All PCs (n = 12/species) spiked with up to 200 colony‐forming units/bag remained sterile until the end of storage when UVC treated 6 hours after spiking. UVC treatment 8 hours after spiking resulted in single breakthrough contaminations with the fast‐growing species Escherichia coli and Streptococcus pyogenes. CONCLUSION The UVC‐based THERAFLEX UV‐Platelets system efficiently inactivates transfusion‐relevant bacterial species in PCs. The comprehensive data from this study may provide a valuable basis for the optimal use of this UVC‐based PI system.

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Section: Discussionmentioning

confidence: 99%

Bacterial inactivation of platelet concentrates with the THERAFLEX UV‐Platelets pathogen inactivation system

et al. 2018

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“…In order to assess inactivation efficacy, studies spiking pathogens relevant to blood transfusion into PCs prior to illumination have been performed ( 34 , 41 – 44 ). All PI systems currently on the market have demonstrated effectiveness in inactivating most tested pathogens with moderate to highly effective inactivation capacities for several emerging viruses including West Nile virus ( 45 ), chikungunyah virus ( 46 ), Zika virus ( 47 , 48 ), dengue virus ( 49 ), and hepatitis-E-virus ( 50 ).…”

Section: Ongoing Debate: Safety Vs Efficacy Of Pimentioning

confidence: 99%

Ultraviolet-Based Pathogen Inactivation Systems: Untangling the Molecular Targets Activated in Platelets

et al. 2018

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Transfusions of platelets are an important cornerstone of medicine; however, recipients may be subject to risk of adverse events associated with the potential transmission of pathogens, especially bacteria. Pathogen inactivation (PI) technologies based on ultraviolet illumination have been developed in the last decades to mitigate this risk. This review discusses studies of platelet concentrates treated with the current generation of PI technologies to assess their impact on quality, PI capacity, safety, and clinical efficacy. Improved safety seems to come with the cost of reduced platelet functionality, and hence transfusion efficacy. In order to understand these negative impacts in more detail, several molecular analyses have identified signaling pathways linked to platelet function that are altered by PI. Because some of these biochemical alterations are similar to those seen arising in the context of routine platelet storage lesion development occurring during blood bank storage, we lack a complete picture of the contribution of PI treatment to impaired platelet functionality. A model generated using data from currently available publications places the signaling protein kinase p38 as a central player regulating a variety of mechanisms triggered in platelets by PI systems.

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“…) . These technologies provide the opportunity to reduce the risk of septic transfusion reactions from bacterially contaminated platelet concentrates, but the disadvantages are their high costs and their limited effectiveness on spores and fast‐growing bacteria . Moreover, pathogen‐reduction technologies cannot be applied to products derived from cellular engineering.…”

Section: Discussionmentioning

confidence: 99%

Combining culture and microbead‐based immunoassay for the early and generic detection of bacteria in platelet concentrates

et al. 2018

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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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Efficiency of riboflavin and ultraviolet light treatment against high levels of biofilm‐derived Staphylococcus epidermidis in buffy coat platelet concentrates

Cited by 16 publications

References 35 publications

Bacterial inactivation of platelet concentrates with the THERAFLEX UV‐Platelets pathogen inactivation system

Bacterial inactivation of platelet concentrates with the THERAFLEX UV‐Platelets pathogen inactivation system

Ultraviolet-Based Pathogen Inactivation Systems: Untangling the Molecular Targets Activated in Platelets

Combining culture and microbead‐based immunoassay for the early and generic detection of bacteria in platelet concentrates

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