Department of Pathology and Surgery, Division of Transfusion Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
J Clin Microbiol. 2018 Nov 27;56(12). doi: 10.1128/JCM.01363-18. Print 2018 Dec.
Although transfusion-transmitted bacterial infection is relatively rare, mitigation of bacterial contamination of platelet units is arguably the top current transfusion-related safety concern. Several different technologies have been employed to detect or neutralize bacteria in platelet concentrates. However, studies of the efficacy of these systems have been hampered by problematic definitions of what represents a "true-positive" versus a "false-positive" culture result. In the current issue of the (M. Cloutier, M.-È. Nolin, H. Daoud, A. Jacques, M. J. de Grandmont, É Ducas, G. Delage, and L. Thibault, J Clin Microbiol 56:e01105-18, 2018, https://doi.org/10.1128/JCM.01105-18), it was demonstrated that the growth of is inhibited by the platelet storage environment, which may explain why the results of initial positive platelet cultures are not always confirmed by subsequent cultures later during the storage period. This important finding is at odds with the generally held belief within the field of transfusion medicine that initially positive platelet cultures that are not confirmed on repeat testing are instrumentation-based false positives. The clinical risk profile of organisms demonstrating storage-related low viability is worthy of further study.
尽管输血传播的细菌感染相对较少，但减轻血小板单位的细菌污染可说是当前与输血相关的头号安全关注点。已经采用了几种不同的技术来检测或中和血小板浓缩物中的细菌。然而，这些系统的功效研究受到对何为“真正阳性”和何为“假阳性”培养结果的有问题的定义的阻碍。在本期 （M. Cloutier、M.-È. Nolin、H. Daoud、A. Jacques、M. J. de Grandmont、É Ducas、G. Delage 和 L. Thibault，J Clin Microbiol 56:e01105-18, 2018, https://doi.org/10.1128/JCM.01105-18）中，证明 的生长受到血小板储存环境的抑制，这可能解释了为什么初始阳性的血小板培养物的结果并不总是在储存期内的后续培养中得到确认。这一重要发现与输血医学领域普遍持有的观点相悖，该领域普遍认为，在重复检测中未得到确认的初始阳性血小板培养物是基于仪器的假阳性。表现出与储存相关的低活力的生物体的临床风险特征值得进一步研究。
