Influence of blood prestorage conditions and white blood cell filtration on the bacterial load of blood deliberately inoculated with Gram-positive and Gram-negative pathogens
L. Siblini
Laboratoire de Bactériologie-Virologie, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
Etablissement Français du Sang Auvergne-Loire, Saint-Etienne, France
Search for more papers by this authorB. Lafeuillade
Etablissement Français du Sang Auvergne-Loire, Saint-Etienne, France
Search for more papers by this authorA. Ros
Laboratoire de Bactériologie-Virologie, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
Search for more papers by this authorO. Garraud
Etablissement Français du Sang Auvergne-Loire, Saint-Etienne, France
Search for more papers by this authorCorresponding Author
B. Pozzetto
Laboratoire de Bactériologie-Virologie, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
Correspondence: Bruno Pozzetto, Laboratoire de Bactériologie-Virologie, Hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 02, France E-mail: [email protected]Search for more papers by this authorL. Siblini
Laboratoire de Bactériologie-Virologie, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
Etablissement Français du Sang Auvergne-Loire, Saint-Etienne, France
Search for more papers by this authorB. Lafeuillade
Etablissement Français du Sang Auvergne-Loire, Saint-Etienne, France
Search for more papers by this authorA. Ros
Laboratoire de Bactériologie-Virologie, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
Search for more papers by this authorO. Garraud
Etablissement Français du Sang Auvergne-Loire, Saint-Etienne, France
Search for more papers by this authorCorresponding Author
B. Pozzetto
Laboratoire de Bactériologie-Virologie, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
Correspondence: Bruno Pozzetto, Laboratoire de Bactériologie-Virologie, Hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 02, France E-mail: [email protected]Search for more papers by this authorAbstract
Background and Objectives Currently, the bacterial contamination of blood constitutes one of the major infectious risks of transfusion. The aim of this study was to evaluate the bactericidal effect of blood on various bacterial species and to determine the influence of prestorage conditions and white blood cell (WBC) filtration on the reduction of the bacterial load in isolated red blood cells (RBCs).
Materials and Methods The growth kinetics of eight different species of bacteria were studied at 20 °C in deliberately contaminated RBC units. Further experiments evaluated the effect of prestorage conditions and WBC filtration on the viability of two model bacteria (Klebsiella oxytoca and Staphylococcus epidermidis) in comparison to previous results obtained with Yersinia enterocolitica.
Results For bacteria susceptible to the bactericidal effect of blood (mainly Gram-negative rods), a reduction of the bacterial load was obtained within 2 h of prestorage at 20 °C. When the prestorage period was prolonged beyond 3 h at 20 °C, rapid growth was observed with some Enterobacteriaceae. Whereas WBC filtration reduced dramatically the viability of Y. enterocolitica, it had only a minimal effect on the viability of S. epidermidis and K. oxytoca. However, the two latter species of bacteria did not survive prolonged storage at 4 °C.
Conclusions Experiments conducted under realistic conditions are needed to determine whether it would be worthwhile recommending the rapid storage of RBCs at 4 °C after WBC reduction of the blood product.
References
- 1 Blajchman MA: Bacterial contamination of blood products. Transfus Apheresis Sci 2001; 24: 245
- 2 Perez P, Ngombet R, Debeir J, Noel L, Sari F: Les incidents transfusionnels par contamination bactérienne: synthèse de la littérature et des données d’hémovigilance. Transfus Clin Biol 1998; 5: 203–210
- 3 Roth VR, Kuehnert MJ, Haley NR, Gregory KR, Schreiber GB, Arduino MJ, Holt SC, Carson LA, Elder KV, Jarvis WR: Evaluation of a reporting system for bacterial contamination of blood components in the United States. Transfusion 2001; 41: 1486–1492
- 4 Andreu G, Morel P, Forestier F, Debeir J, Rebibo D, Janvier G, Hervé P: Haemovigilance network in France: Organization and analysis of immediate transfusion incident reports from 1994 to 1998. Transfusion 2002; 42: 1356–1364
- 5 Barbara J: The rationale for pathogen inactivation treatment of platelet components – instruction. Semin Hematol 2001; 38: 1–3
- 6 Corash L: Inactivation of infectious pathogens in labile blood components: meeting the challenge. Transfus Clin Biol 2001; 8: 138–145
- 7 Yomtovian R: Novel methods for detection of platelet bacterial contamination. Vox Sang 2002; 83: 129–131
- 8 Burnouf T, Radosevich M: Reducing the risk of infection from plasma products: specific preventative strategies. Blood Rev 2000; 14: 94–110
- 9 Sanchez M, Schreiber GB, Glynn SA, Bethel J, Kessler D, Chang D, Zuck TF: Blood-donor perceptions of history screening with a computer-assisted self-administrated interview. Transfusion 2003; 43: 165–172
- 10 Morel P, Naegelen C, Masse M, Lamy C, Leprat R, Talon D: Suivi de la biocontamination de l’environnement des produits sanguins labiles: place dans une démarche d’action qualité. Transfus Clin Biol 1998; 5: 251–259
- 11 Perez P, Bruneau C, Chassaigne M, Salmi LR, Noel L, Allouch P, Audurier A, Gulian C, Janus G, Boulard G, De Micco P: Multivariate analysis of determinants of bacterial contamination of whole-blood donation. Vox Sang 2002; 82: 55–60
- 12 Wagner SJ, Robinette D, Friedman LI, Miripol J: Diversion of initial blood flow to prevent whole-blood contamination by skin surface bacteria: an in vitro model. Transfusion 2000; 40: 335–338
- 13 Bruneau C, Perez P, Chassaigne M, Allouch P, Audurier A, Gulian C, Janus G, Boulard G, De Micco P: Efficacy of a new collection procedure for preventing bacterial contamination of whole-blood donations. Transfusion 2001; 41: 74–81
- 14 De Korte D, Marcelis JH, Verhoeven AJ, Soeterboek AM: Diversion of first blood volume results in a reduction of bacterial contamination of whole-blood collections. Vox Sang 2002; 83: 13–16
- 15 Pietersz RN, Reesink HW, Pauw W, Dekker WJ, Buisman L: Prevention of Yersinia enterocolitica growth in red-blood-cell concentrates. Lancet 1992; 340: 755–756
- 16 Reesink HW, Hamfland P, Hertfelder HG, Scharf RE: What is the optimal storage temperature for whole blood prior to preparation of blood components. International Forum. Vox Sang 1993; 65: 320–327
- 17 Lane TA: Leukocyte depletion of cellular blood components. Curr Opin Hematol 1994; 6: 443–451
- 18 Sirchia G, Rebulla P, Sabioneda L, Garcea F, Greppi N: Optimal conditions for white cell reduction in red cells by filtration at the patient's beside. Transfusion 1996; 36: 322–327
- 19 Sirchia G, Rebulla P: Evidence-based medicine: the case for white cell reduction. Transfusion 1997; 37: 543–549
- 20 Siblini L, Lafeuillade B, Ros A, Le Petit JC, Pozzetto B: Reduction of Yersinia enterocolitica load in deliberately inoculated blood: the effects of blood prestorage temperature and WBC filtration. Transfusion 2002; 42: 422–427
- 21 Goldman M, Blajchman MA: Blood product-associated bacterial species. Transfus Med Rev 1991; 5: 73–83
- 22 Sazama K: Bacteria in blood for transfusion. Arch Pathol Lab Med 1994; 118: 350–365
- 23 Wagner SJ, Friedman LI, Dodd RY: Transfusion-associated bacterial sepsis. Clin Microbiol Rev 1994; 7: 290–302
- 24 Noël L: Assurance qualité et incidents bactériens liés à la transfusion sanguine. Transfus Cin Biol 1996; 1: 35–42
- 25 Klein HG, Dodd RY, Ness PM, Fratantoni JA, Nemo GJ: Current status of microbial contamination of blood components: summary of a conference. Transfusion 1997; 37: 95–101
- 26 Morel P, Leconte des Floris MF, Bardiaux L, Pouthier F, Hervé P: Transfusion sanguine et risque bactérien. Transfus Clin Biol 2000; 7: 15–23
- 27 Perez P, Salmi R, Follea G, Schmit JL, De Barbeyrac B, Sudre P, Salamon R: Determinants of transfusion-associated bacterial contamination: results of the French Bacthem case-control study. Transfusion 2001; 41: 862–872
- 28 Wenz B, Ciavarella D, Freundlich L: Effect of prestorage white cell reduction of bacterial growth in platelet concentrates. Transfusion 1993; 33: 520–523
- 29 Buchholz DH, AuBuchon JP, Snyder EL, Kandler R, Piscitelli V, Pickard C, Napychank P, Edberg S: Effect of white cell reduction on the resistance of blood components to bacterial multiplication. Transfusion 1994; 34: 852–857
- 30 Holden F, Foley M, Devin G, Kinsella A, Murphy WG: Coagulase negative staphylococcal contamination of whole blood and its components: the effect of WBC reduction. Transfusion 2000; 40: 1508–1513
- 31 Högman CF, Gong J, Ericson L, Hambraus A, Johansson CS: White cells protect donor blood against bacterial contamination. Transfusion 1991; 31: 620–626
- 32 Sanz C, Pereira A, Vila J, Faundez A-I, Gomez J, Ordinas A: Growth of bacteria in platelet concentrates obtained from whole blood stored for 16 hours at 22°C before component preparation. Transfusion 1997; 37: 251–254
- 33 Gong J, Högman CF, Hambraeus A, Johansson CS, Eriksson L: Transfusion-associated Serratia marcescens infection: studies of the mechanism of action. Transfusion 1993; 33: 802–808
- 34 Wenz B, Ciavarella D, Freundlich L: Effect of prestorage white cell reduction on bacterial growth in platelet concentrates. Transfusion 1993; 33: 520–523
- 35 Wagner SJ, Robinette D, Nazario M, Moroff G: Bacteria levels in components prepared from deliberately inoculated whole blood held for 8 or 24 hours at 20–24 °C. Transfusion 1995; 35: 911–916
- 36 Högman CF, Gong J, Hambraeus A, Johansson CS, Eriksson L: The role of white cells in the transmission of Yersinia enterocolitica in blood components. Transfusion 1992; 32: 654–657
- 37 Nusbacher J: Yersinia enterocolitica and white cell filtration. Transfusion 1992; 32: 597–600
- 38 Gong J, Högman CF, Hambraeus A, Johansson CS, Eriksson L: Transfusion-transmitted Yersinia enterocolitica infection. Protection through buffy coat removal and failure of the bacteria to grow in platelet-rich or platelet-poor plasma. Vox Sang 1993; 65: 4–6
- 39 Heal JM, Cohen HJ: Do white cells in stored blood components reduce the likelihood of post transfusion bacterial sepsis? Transfusion 1991; 31: 581–583
- 40 Buchholz DH, AuBuchon JP, Snyder EL, Kandler R, Edberg S, Piscitelli V, Pickard C, Napychank P: Removal of Yersinia enterocolitica from AS-1 red cells. Transfusion 1992; 32: 667–672
- 41 Gibb AP, Martin KM, Davidson GA, Walker B, Murphy WG: Modeling the growth of Yersinia enterocolitica in donated blood. Transfusion 1994; 34: 304–310
Citing Literature
