Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.
Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
Vox Sang. 2024 Jul;119(7):693-701. doi: 10.1111/vox.13640. Epub 2024 Apr 17.
Platelet concentrates (PC) are stored at 20-24°C to maintain platelet functionality, which may promote growth of contaminant bacteria. Alternatively, cold storage of PC limits bacterial growth; however, data related to proliferation of psychotrophic species in cold-stored PC (CSP) are scarce, which is addressed in this study.
Eight laboratories participated in this study with a pool/split approach. Two split PC units were spiked with 25 colony forming units (CFU)/PC of Staphylococcus aureus, Klebsiella pneumoniae, Serratia liquefaciens, Pseudomonas fluorescens and Listeria monocytogenes. One unit was stored under agitation at 20-24°C/7 days while the second was stored at 1-6°C/no agitation for 21 days. PC were sampled periodically to determine bacterial loads. Five laboratories repeated the study with PC inoculated with lyophilized inocula (30 CFU/mL) of S. aureus and K. pneumoniae.
All species proliferated in PC stored at 20-24°C, reaching concentrations of ≤10 CFU/mL by day 7. Psychrotrophic P. fluorescens and S. liquefaciens proliferated in CSP to ~10 CFU/mL and ~10 CFU/mL on days 10 and 17 of storage, respectively, followed by L. monocytogenes, which reached ~10 CFU/mL on day 21. S. aureus and K. pneumoniae did not grow in CSP.
Psychrotrophic bacteria, which are relatively rare contaminants in PC, proliferated in CSP, with P. fluorescens reaching clinically significant levels (≥10 CFU/mL) before day 14 of storage. Cold storage reduces bacterial risk of PC to levels comparable with RBC units. Safety of CSP could be further improved by implementing bacterial detection systems or pathogen reduction technologies if storage is beyond 10 days.
血小板浓缩物(PC)在 20-24°C 下储存以维持血小板功能,这可能会促进污染物细菌的生长。或者,PC 的低温储存限制了细菌的生长;然而,关于低温储存的 PC(CSP)中精神细菌的增殖的数据很少,本研究对此进行了探讨。
8 个实验室参与了这项研究,采用分组方法。将约 25 个集落形成单位(CFU)/PC 的金黄色葡萄球菌、肺炎克雷伯菌、液化沙雷氏菌、荧光假单胞菌和单核细胞增生李斯特菌分别接种到 2 个 PC 等分物中。一个单位在 20-24°C/7 天的搅拌下储存,而第二个单位在 1-6°C/无搅拌下储存 21 天。定期取样 PC 以确定细菌负荷。5 个实验室用冻干接种物(~30 CFU/mL)重复了这项研究,接种物为金黄色葡萄球菌和肺炎克雷伯菌。
所有物种在 20-24°C 储存的 PC 中增殖,在第 7 天达到≤10 CFU/mL 的浓度。嗜冷荧光假单胞菌和液化沙雷氏菌在 CSP 中增殖至10 CFU/mL 和10 CFU/mL,分别在储存的第 10 天和第 17 天,随后是单核细胞增生李斯特菌,在第 21 天达到~10 CFU/mL。金黄色葡萄球菌和肺炎克雷伯菌在 CSP 中未生长。
相对罕见的 PC 污染物嗜冷细菌在 CSP 中增殖,荧光假单胞菌在储存的第 14 天之前达到临床显著水平(≥10 CFU/mL)。低温储存将 PC 的细菌风险降低到与 RBC 单位相当的水平。如果储存时间超过 10 天,可以通过实施细菌检测系统或病原体减少技术进一步提高 CSP 的安全性。