Brecher M E, Boothe G, Kerr A
Transfusion Medicine Service, University of North Carolina Hospitals, Chapel Hill.
Transfusion. 1993 Jun;33(6):450-7. doi: 10.1046/j.1537-2995.1993.33693296805.x.
Because of the rising incidence of bacterial growth and septic platelet transfusions in aging units, platelet storage is currently limited in the United States to 5 days. This approved shelf life of platelets might be altered if methods were devised to rapidly detect infected units and/or to decrease the incidence of bacterially contaminated platelets. An investigation was conducted on the effect of a prototype blood collection system with an in-line filter for the production of white cell-reduced platelet-rich plasma on the growth of bacteria in platelets prepared from whole blood that had been inoculated with Staphylococcus epidermidis. Additional studies were conducted with a chemiluminescence-linked ribosomal RNA (rRNA) gene probe and with blood gas analysis to identify possible methods for the rapid detection of bacterial contamination. All units were followed for 9 days of storage. The filtration of the platelet-rich plasma resulted in an approximate 2 log10 reduction in white cells with an average loss of 6.7 percent of platelets. Filtration did not appear to alter bacterial growth. In all platelet units that supported growth, pO2 dropped to negligible values and pCO2 rose relative to culture-negative units. The changes were most sensitive and specific beyond 5 days of storage. The universal bacterial rRNA probe assay was able to detect S. epidermidis in concentrations as low as 1 x 10(3) colony-forming units per mL in some cases and reliably detected all units contaminated at a concentration of 1 x 10(4) colony-forming units per mL.(ABSTRACT TRUNCATED AT 250 WORDS)
由于老化血袋中细菌生长和感染性血小板输注的发生率不断上升,目前美国将血小板储存期限限制在5天。如果能设计出快速检测受感染血袋的方法和/或降低细菌污染血小板的发生率,那么目前批准的血小板保质期可能会改变。本研究探讨了一种带有在线过滤器的原型采血系统,用于生产白细胞减少的富含血小板血浆,对用表皮葡萄球菌接种的全血制备的血小板中细菌生长的影响。另外还进行了化学发光连接核糖体RNA(rRNA)基因探针和血气分析的研究,以确定快速检测细菌污染的可能方法。所有血袋均储存9天。富含血小板血浆的过滤使白细胞数量减少了约2个对数级,平均血小板损失率为6.7%。过滤似乎并未改变细菌的生长。在所有支持细菌生长的血小板血袋中,与培养阴性的血袋相比,pO2降至可忽略不计的值,pCO2升高。这些变化在储存5天后最为敏感和特异。通用细菌rRNA探针检测法在某些情况下能够检测到低至每毫升1×10(3) 菌落形成单位的表皮葡萄球菌,并且能够可靠地检测到所有每毫升1×10(4) 菌落形成单位浓度污染的血袋。(摘要截短于250字)