Brecher M E, Means N, Jere C S, Heath D, Rothenberg S, Stutzman L C
University of North Carolina Hospitals, Chapel Hill, North Carolina 27514, USA.
Transfusion. 2001 Apr;41(4):477-82. doi: 10.1046/j.1537-2995.2001.41040477.x.
Approximately 1 in 2000 platelet components are bacterially contaminated. The time to detection of 15 seeded organisms in platelets recovered from an automated culture system was studied.
Isolates of Bacillus cereus, Bacillus subtilis, Candida albicans, Clostridium perfringens, Corynebacterium species, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Propionibacterium acnes, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Serratia marcescens, Streptococcus pyogenes, and Streptococcus viridans were inoculated into Day 2 apheresis platelet components to obtain a final concentration of approximately 10 and 100 CFU per mL (2 units/organism). Each bag was sampled 10 times (20 mL/sample). Four mL of each sample was inoculated into standard aerobic and anaerobic bottles and into aerobic and anaerobic bottles containing charcoal; 2 mL was inoculated into pediatric aerobic bottles (so as to maintain a 1:10 ratio of sample to media) and 1 mL into thioglycollate broth.
With the exception of P. acnes, all organisms were detected in a mean of 9.2 to 25.6 hours. A range of 10 serial dilutions in inoculating concentrations was associated with an overall 10.1-percent difference in detection time. A mean of 74.4 and 86.2 hours (100 and 10 CFU/mL inocula, respectively) was required for the detection of P. acnes in anaerobic bottles.
Bacteria thought to be clinically significant platelet contaminants can be detected in 9.2 to 25.6 hours when the starting concentration is approximately 10 to 100 CFU per mL. P. acnes required considerably longer incubation times for detection (in either aerobic or anaerobic bottles). However, P. acnes is of questionable clinical significance. Such a detection system could be used in either a blood collection center or a transfusion service to screen platelet concentrates for bacterial contamination. Such testing (with sterile sampling performed so as to maintain a closed-bag system) would be expected to save lives and might allow an extension of platelet storage.
每2000个血小板成分中约有1个被细菌污染。研究了从自动培养系统中回收的血小板中15种接种微生物的检测时间。
将蜡样芽孢杆菌、枯草芽孢杆菌、白色念珠菌、产气荚膜梭菌、棒状杆菌属、阴沟肠杆菌、大肠埃希菌、产酸克雷伯菌、痤疮丙酸杆菌、铜绿假单胞菌、金黄色葡萄球菌、表皮葡萄球菌、粘质沙雷菌、化脓性链球菌和草绿色链球菌的分离株接种到第2天的单采血小板成分中，使最终浓度约为每毫升10和100 CFU（每种微生物2个单位）。每个袋子采样10次（每次20 mL）。将每个样品的4 mL接种到标准需氧瓶和厌氧瓶以及含活性炭的需氧瓶和厌氧瓶中；2 mL接种到儿科需氧瓶中（以保持样品与培养基1:10的比例），1 mL接种到硫乙醇酸盐肉汤中。
除痤疮丙酸杆菌外，所有微生物的平均检测时间为9.2至25.6小时。接种浓度的10倍系列稀释范围与检测时间的总体差异为10.1%相关。在厌氧瓶中检测痤疮丙酸杆菌分别需要平均74.4小时和86.2小时（接种量分别为100和10 CFU/mL）。
当起始浓度约为每毫升10至100 CFU时，被认为具有临床意义的血小板污染细菌可在9.2至25.6小时内检测到。痤疮丙酸杆菌的检测需要相当长的培养时间（在需氧瓶或厌氧瓶中）。然而，痤疮丙酸杆菌的临床意义存疑。这样的检测系统可用于血液采集中心或输血服务机构，以筛查血小板浓缩物是否受到细菌污染。这种检测（通过无菌采样以保持袋封闭系统）有望挽救生命，并可能延长血小板的储存时间。
