Research and Development, ZEUS Scientific, Raritan, New Jersey.
Transfusion. 2014 Jun;54(6):1642-51. doi: 10.1111/trf.12487. Epub 2013 Nov 5.
Transfusion of bacterially contaminated platelet concentrates (PCs) can result in serious health consequences for the affected patient. Before being released from blood banking facilities, PCs are routinely screened for bacterial contamination by culture-based tests. However, culture-based PC screening methods require extended holding and incubation periods and are prone to false-negative results due to sampling error. Screening PCs closer to the time of transfusion using rapid point-of-issue tests represents an alternative approach; however, FDA-approved assays generally suffer from a lack of sensitivity.
Presented herein is the feasibility of a novel approach toward rapid, sensitive, and universal detection of bacterially contaminated PCs via selective measurement of microbial DNA polymerase activity. This approach is achieved using a differential cell lysis procedure in combination with enzymatic template generation and amplification (termed ETGA-PC assay).
Serial dilution spiking experiments revealed an approximate sensitivity of 30 to 200 colony-forming units (CFUs)/mL (mean, 85 CFUs/mL) for Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. An additional 22 clinically relevant strains of bacteria were also detected below 200 CFUs/mL after spiking into PC aliquots. Furthermore, the ETGA-PC assay was able to accurately monitor the presence and growth of seven clinically relevant bacterial species that were spiked into PC units.
Together, the data presented here demonstrate that the ETGA-PC assay is a feasible approach for rapid and sensitive detection of bacterially contaminated PCs. Experiments, aimed at simplification and/or automation of the assay procedure, are under way.
输注细菌污染的血小板浓缩物(PC)可能会对受影响的患者造成严重的健康后果。在从血库设施放行之前,PC 通常通过基于培养的测试来筛查细菌污染。然而,基于培养的 PC 筛选方法需要延长保持和孵育时间,并且由于采样错误容易出现假阴性结果。使用快速即时检测方法在更接近输血时筛选 PC 是一种替代方法;然而,FDA 批准的检测方法通常存在灵敏度不足的问题。
本文提出了一种通过选择性测量微生物 DNA 聚合酶活性来快速、敏感和普遍检测细菌污染的 PC 的新方法的可行性。该方法通过使用差异细胞裂解程序与酶模板生成和扩增(称为 ETGA-PC 测定法)相结合来实现。
连续稀释接种实验表明,表皮葡萄球菌、金黄色葡萄球菌、大肠杆菌和肺炎克雷伯菌的检测灵敏度约为 30 至 200 个菌落形成单位(CFU)/mL(平均值 85 CFU/mL)。另外,在将 22 种临床相关细菌接种到 PC 等分试样中后,也可以检测到低于 200 CFU/mL 的浓度。此外,ETGA-PC 测定法能够准确监测七种临床相关细菌物种的存在和生长,这些细菌被接种到 PC 单位中。
综上所述,本文提供的数据表明,ETGA-PC 测定法是一种快速、敏感检测细菌污染 PC 的可行方法。正在进行简化和/或自动化测定程序的实验。