Bello-López J M, Delgado-Balbuena L, Rojas-Huidobro D, Rojo-Medina J
Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360 México City, Mexico; Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Zacatenco, Gustavo A. Madero, 07360 México City, Mexico.
Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360 México City, Mexico.
Transfus Clin Biol. 2018 Sep;25(3):197-203. doi: 10.1016/j.tracli.2018.03.004. Epub 2018 Apr 12.
Transfusion of hemocomponents is essential for clinical and surgical procedures and therefore their safety has increased. An option for pathogen reduction includes the combination of riboflavin and UV light. To our knowledge, there are no studies in Latin America that demonstrate the effectiveness of the pathogen reduction in hemocomponents. The objective of this work was to evaluate the efficiency of a pathogens reduction system in platelets concentrates (PC) and plasma.
PC and plasma were contaminated with Escherichia coli, Klebsiella pneumoniae, Streptococcus pyogenes and Staphylococcus epidermidis at 10 to 10 CFU and subjected to bacterial reduction. After bacterial reduction, hemocomponents were subjected to cultivation of surviving bacteria by automated method and classical colonies quantification. Additionally, quality control testing was performed in order to confirm the integrity of platelets and coagulation laboratory values in plasma before and after bacterial reduction.
The bacterial death in PC/plasma was expressed by Logarithmic Reduction Value as follows: for both strains (E. coli and S. pyogenes) 4/4, 5/5 and 6/6; for K. pneumoniae 2.54/2.23, 2.94/2.22 and 3.44/2.98, for S. epidermidis 4/4, 3.11/5 and 3.23/4.19, for 10, 10 and 10 CFU, respectively. In PC and plasma, platelet count, pH (at 22°C), activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen, factor VIII and total proteins (TP) were slightly modified.
UV light with riboflavin is able to reduce an important number of pathogens in hemocomponents; however, the bacterial reduction is influenced by the nature and quantity of the pathogen.
血液成分的输注对于临床和外科手术至关重要,因此其安全性已有所提高。病原体灭活的一种方法是核黄素与紫外线联合使用。据我们所知,拉丁美洲尚无研究证明血液成分中病原体灭活的有效性。本研究的目的是评估一种病原体灭活系统对浓缩血小板(PC)和血浆的效果。
将PC和血浆分别接种10至10 CFU的大肠埃希菌、肺炎克雷伯菌、化脓性链球菌和表皮葡萄球菌,然后进行细菌灭活处理。细菌灭活后,采用自动化方法和经典菌落计数法对血液成分中存活的细菌进行培养。此外,进行质量控制检测以确认细菌灭活前后血小板的完整性以及血浆中的凝血实验室指标。
PC/血浆中的细菌死亡情况用对数减少值表示如下:两种菌株(大肠埃希菌和化脓性链球菌)在接种量为10、10和10 CFU时分别为4/4、5/5和6/6;肺炎克雷伯菌分别为2.54/2.23、2.94/2.22和3.44/2.98;表皮葡萄球菌分别为4/4、3.11/5和3.23/4.19。在PC和血浆中,血小板计数、pH值(22°C时)、活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)、纤维蛋白原、因子VIII和总蛋白(TP)均有轻微改变。
核黄素与紫外线联合使用能够减少血液成分中的大量病原体;然而,细菌灭活受到病原体的性质和数量的影响。