Ramirez-Arcos Sandra, Goldman Mindy
Infectious Diseases and Donor and Transplantation Services, Canadian Blood Services, Ottawa, Ontario, Canada.
Transfusion. 2005 Aug;45(8):1275-9. doi: 10.1111/j.1537-2995.2005.00203.x.
The BacT/ALERT (bioMérieux) system is highly efficient for bacterial detection in apheresis platelets (PLTs) and whole blood-derived PLTs produced by the buffy-coat method. Detection of bacterial contamination in whole blood-derived PLTs produced by the PLT-rich plasma (PRP) method, however, is problematic. Prestorage pooling of these PLTs is not permitted in some countries including Canada and the United States, and culturing individual units is costly and may significantly reduce the PLT unit content. In this study, the sensitivity and specificity of BacT/ALERT cultures performed on pools derived from PRP PLTs are reported.
The sensitivity of the BacT/ALERT system was evaluated for bacterial detection in PRP PLTs with a dilution effect. Thirty PLT pools were produced with 1 PLT unit previously spiked with bacteria and then pooled with other four nonspiked PLT units. Three bacteria, usually associated with PLT contamination, were selected for spiking. The specificity of this method was evaluated in 40 nonspiked PLT pools.
The method was found to be 100 percent specific and 97 percent sensitive. Of the five spiked pools with Streptococcus pneumoniae at levels of less than 2 colony-forming units (CFUs) per mL, four were found to be positive whereas all 25 spiked pools with greater than 9 CFUs per mL of any of the chosen bacteria gave positive results. The mean time of detection was 17 to 19 hours for Staphylococcus epidermidis and 14 to 15 hours for S. pneumoniae and Pseudomonas aeruginosa when spiked with similar bacterial inocula.
The evaluated system is highly sensitive and specific and may be a feasible method for bacterial detection in PRP PLTs.
BacT/ALERT(生物梅里埃公司)系统在检测单采血小板(PLT)以及通过白膜层法制备的全血来源PLT中的细菌方面效率很高。然而,检测通过富血小板血浆(PRP)法制备的全血来源PLT中的细菌污染存在问题。在包括加拿大和美国在内的一些国家,不允许对这些PLT进行储存前合并,并且对单个单位进行培养成本高昂,还可能显著减少PLT单位含量。在本研究中,报告了对PRP PLT来源的合并样本进行BacT/ALERT培养的敏感性和特异性。
评估BacT/ALERT系统在有稀释效应的PRP PLT中检测细菌的敏感性。制备了30个PLT合并样本,其中1个PLT单位预先接种细菌,然后与其他4个未接种细菌的PLT单位合并。选择了三种通常与PLT污染相关的细菌进行接种。在40个未接种细菌的PLT合并样本中评估该方法的特异性。
发现该方法特异性为100%,敏感性为97%。在每毫升少于2个菌落形成单位(CFU)水平接种肺炎链球菌的5个合并样本中,4个检测为阳性,而每毫升接种任何一种所选细菌超过9个CFU的所有25个合并样本均呈阳性结果。当接种相似细菌接种量时,表皮葡萄球菌的平均检测时间为17至19小时,肺炎链球菌和铜绿假单胞菌为14至15小时。
所评估的系统高度敏感且特异,可能是检测PRP PLT中细菌的一种可行方法。