Jocić Miodrag, Trkuljić Miroljub, Jovicić Dragana, Borovcanin Nemanja, Todorović Milena, Balint Bela
Military Medical Academy, Institute of Transfusiology, Belgrade, Serbia.
Vojnosanit Pregl. 2011 Dec;68(12):1041-6.
BACKGROUND/AIM: Bacterial contamination of blood components, primarily platelet concentrates (PCs), has been identified as one of the most frequent infectious complications in transfusion practice. PC units have a high risk for bacterial growth/multiplication due to their storage at ambient temperature (20 +/- 2 degrees C). Consequences of blood contamination could be effectively prevented or reduced by pathogen inactivation systems. The aim of this study was to determine the Mirasol pathogen reduction technology (PRT) system efficacy in PCs using an artificial bacteria-contamination model.
According to the ABO blood groups, PC units (n = 216) were pooled into 54 pools (PC-Ps). PC-Ps were divided into three equal groups, with 18 units in each, designed for an artificial bacteria-contamination. Briefly, PC-Ps were contaminated by Staphylococcus epidermidis, Staphylococcus aureus or Escherichia coli in concentrations 10(2) to 10(7) colony forming units (CFU) per unit. Afterward, PC-Ps were underwent to inactivation by Mirasol PRT system, using UV (lambda = 265-370 nm) activated riboflavin (RB). All PC-Ps were assayed by BacT/Alert Microbial Detection System for CFU quantification before and after the Mirasol treatment. Samples from non-inactivated PC-P units were tested after preparation and immediately following bacterial contamination. Samples from Mirasol treated units were quantified for CFUs one hour, 3 days and 5 days after inactivation. Results. A complete inactivation of all bacteria species was obtained at CFU concentrations of 10(2) and 10(3) per PC-P unit through storage/investigation period. The most effective inactivation (10(5) CFU per PC-P unit) was obtained in Escherichia coli setting. Contrary, inactivation of all the three tested bacteria species was unworkable in concentrations of > or = 10(6) CFU per PC-P unit.
Efficient inactivation of investigated bacteria types with a significant CFU depletion in PC-P units was obtained--3 Log for all three tested species, and 5 Log for Escherichia coli. The safety of blood component therapy, primarily the clinical use of PCs can be improved using the Mirasol PRT system.
背景/目的：血液成分的细菌污染，主要是血小板浓缩物（PCs），已被确定为输血实践中最常见的感染性并发症之一。由于PC单位在室温（20±2℃）下储存，其有很高的细菌生长/繁殖风险。病原体灭活系统可有效预防或减少血液污染的后果。本研究的目的是使用人工细菌污染模型确定Mirasol病原体减少技术（PRT）系统对PCs的疗效。
根据ABO血型，将PC单位（n = 216）合并为54个池（PC-Ps）。PC-Ps被分成三个相等的组，每组18个单位，用于人工细菌污染。简而言之，PC-Ps被表皮葡萄球菌、金黄色葡萄球菌或大肠杆菌污染，浓度为每单位10(2)至10(7)菌落形成单位（CFU）。之后，使用紫外线（λ = 265-370 nm）激活的核黄素（RB），通过Mirasol PRT系统对PC-Ps进行灭活。在Mirasol处理前后，所有PC-Ps均通过BacT/Alert微生物检测系统进行CFU定量分析。未灭活的PC-P单位的样品在制备后和细菌污染后立即进行检测。来自Mirasol处理单位的样品在灭活后1小时、3天和5天进行CFU定量分析。结果。在整个储存/研究期间，在每PC-P单位CFU浓度为10(2)和10(3)时，所有细菌种类均实现完全灭活。在大肠杆菌环境中获得了最有效的灭活效果（每PC-P单位10(5) CFU）。相反，在每PC-P单位≥10(6) CFU的浓度下，对所有三种测试细菌种类的灭活均不可行。
在所研究的细菌类型中实现了高效灭活，PC-P单位中的CFU显著减少——所有三种测试菌种减少3个对数，大肠杆菌减少5个对数。使用Mirasol PRT系统可提高血液成分治疗的安全性，主要是PCs的临床应用安全性。
