Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Vox Sang. 2012 Jul;103(1):1-9. doi: 10.1111/j.1423-0410.2011.01572.x. Epub 2011 Dec 8.
Bacterial contamination of platelet concentrates still represents a major risk in transfusion medicine, and a variety of screening methods have been available to improve the safety of PCs. In the present study, the analytical quality of three different rapid screening methods (BactiFlow flow cytometry, Pan Genera Detection Assay, 23S rRNA RT-PCR) was evaluated in an inter-laboratory comparison in three different German blood services.
Samples were inoculated with different bacteria [Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli (two strains), Klebsiella pneumoniae (two strains), Enterobacter aerogenes (one strain), Serratia marcescens (one strain)] at different counts (4·5 × 10(3) -4·5 × 10(8) CFU/ml) alternating with negative samples in one transfusion facility. Samples were blinded with a random order for each screening method, shipped to partners and analysed immediately after receipt with different rapid screening methods.
The inter-laboratory comparison revealed that the BactiFlow assay and 23S rRNA RT-PCR-screening detected all samples correctly (positive: 12/12, negative: 8/8). The Pan Genera Detection Assay test detected only four of the positive samples. Four of the non-detected positive samples were below the assay's detection limit. Another four inoculated samples with comparatively high bacteria counts were detected false negative (E. coli (two strains): 9·87 × 10(5) and 2·10 × 10(7) CFU/ml, respectively, K. pneumoniae: 4·79 × 10(6) CFU/ml, S. aureus: 6·03 × 10(5) CFU/ml). All rapid screening methods revealed no false-positive results.
Both BactiFlow and 23S rRNA RT-PCR demonstrated a high sensitivity to detecting bacterial contamination in PCs. The Pan Genera Detection Assay had some shortcomings regarding sensitivity, especially for the detection of Gram-negative strains.
血小板浓缩物的细菌污染仍然是输血医学中的一个主要风险,已经有多种筛选方法可用于提高 PCs 的安全性。在本研究中,三种不同的快速筛选方法(BactiFlow 流式细胞术、Pan Genera Detection Assay、23S rRNA RT-PCR)的分析质量在三个不同的德国血库的实验室间比较中进行了评估。
在一个输血机构中,将不同的细菌(金黄色葡萄球菌、表皮葡萄球菌、大肠杆菌(两种株)、肺炎克雷伯菌(两种株)、产气肠杆菌(一株)、黏质沙雷菌(一株))以不同的数量(4.5×10(3) -4.5×10(8) CFU/ml)接种到样本中,然后与阴性样本交替。在每个筛选方法中,将样本用随机顺序进行盲检,然后运送到合作伙伴处,在收到后立即用不同的快速筛选方法进行分析。
实验室间比较显示,BactiFlow 检测和 23S rRNA RT-PCR 筛选正确检测到所有样本(阳性:12/12,阴性:8/8)。Pan Genera Detection Assay 检测仅检测到其中的 4 个阳性样本。4 个未检测到的阳性样本低于检测限。另外 4 个接种了高数量细菌的样本被错误地检测为阴性(大肠杆菌(两种株):分别为 9.87×10(5) 和 2.10×10(7) CFU/ml,肺炎克雷伯菌:4.79×10(6) CFU/ml,金黄色葡萄球菌:6.03×10(5) CFU/ml)。所有快速筛选方法均未显示假阳性结果。
BactiFlow 和 23S rRNA RT-PCR 均显示出对 PCs 中细菌污染的高灵敏度。Pan Genera Detection Assay 在灵敏度方面存在一些缺陷,特别是对革兰氏阴性菌的检测。