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Roslyn Yomtovian - One of the best experts on this subject based on the ideXlab platform.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
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relationship between bacterial load species virulence and Transfusion reaction with Transfusion of bacterially contaminated platelets
Clinical Infectious Diseases, 2008Co-Authors: Michael R. Jacobs, Hillard M Lazarus, Caryn E Good, Roslyn YomtovianAbstract:BACKGROUND Bacterial contamination is currently the major infectious hazard of platelet Transfusion, but associations between bacterial species and quantity and Transfusion Reactions have not been characterized. METHODS Patients receiving platelets from July 1991 through December 2006 were observed using active surveillance by quantitative culture of platelets at the time of issue or passive surveillance by investigation of clinical Reactions in patients and culture of implicated units. Patient Reactions were classified by type and severity and were correlated with bacterial species and number. Endotoxin content of gram-negative contaminants was determined by limulus lysate assay. RESULTS Fifty-two bacterially contaminated platelet units were detected (50 by active and 2 by passive surveillance). Rates of bacterial contamination and septic Transfusion Reactions were 32.0-fold and 10.6-fold higher, respectively, as determined by active versus passive surveillance (P or =10(5) colony-forming units/mL and higher bacterial virulence. A detection method with a 10(3) colony-forming units/mL threshold would detect >90% of contaminants. CONCLUSIONS Active surveillance detected 32-fold more bacterially contaminated platelet units and 10.6-fold more septic Reactions than did passive surveillance, and virulent species and bacterial counts of > or =10(5) colony-forming units/mL were associated with more-severe Transfusion Reactions. Improved detection methods or use of pathogen inactivation technology are needed to eliminate this problem.
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prevalence of platelet Transfusion Reactions before and after implementation of leukocyte depleted platelet concentrates by filtration
Vox Sanguinis, 1993Co-Authors: Lawrence T Goodnough, Hillard M Lazarus, James Riddell, Theresa L Chafel, Greg Prince, Donna Hendrix, Roslyn YomtovianAbstract:To determine the impact of platelet leukodepletion by filtration on the overall prevalence of reported Transfusion Reactions associated with platelet concentrates, we audited platelet Transfusion Reactions after infusion of platelet concentrates reported at University Hospitals of Cleveland over 6 months before (interval 1, July 1, 1989 to December 31, 1989) and after (interval 2, July 1, 1990 to December 31, 1990) implementation of the Pall PL 50 filter on our adult Hematology-Oncology inpatient unit (Division 60). Thirty-two (1.7%) of 1,901 random, pooled platelet Transfusion events resulted in blood bank Transfusion reaction workups in interval 1, compared to 90 (5.3%) of 1,704 in interval 2 (p < 0.001). The Division 60 service accounted for more of our hospital-wide platelet Reactions after implementation of the filter in interval 2 (84%) than before filtration in interval 1 (42%), p = 0.002. The prevalence of reaction workups for Division 60 was 0.6% for interval 1, compared to 4.3% for interval 2 (p < 0.001). No differences were found between interval 1 and interval 2 for the rate of discontinuation of platelet Transfusion (36 vs. 32%, p = 0.14), rate of premedication for platelet Transfusion (72 vs. 65%, p = 0.6), percentage of direct antiglobulin test-positive Reactions (17 vs. 5.4%, p = 0.09), percentage showing icteric/hemolyzed serum (15 vs. 4.4%, p = 0.09), or Reactions believed to be due to red blood cell incompatibility (8.8 vs. 1.1%, p = 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)
Paul M Ness - One of the best experts on this subject based on the ideXlab platform.
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solvent detergent treated pooled plasma and reduction of allergic Transfusion Reactions
Transfusion, 2020Co-Authors: Andrea M Mcgonigle, Paul M Ness, Karen E King, Aaron A R Tobian, Sandra K Thoman, Eshan U Patel, Kevin M Waters, Alison R Moliterno, Sonja O Vozniak, Parvez M LokhandwalaAbstract:Background Thrombotic thrombocytopenic purpura (TTP) patients have increased risk for allergic Transfusion Reactions (ATR) due to the number of plasma products they require. This study evaluated the efficacy of solvent detergent treated plasma (S/D treated plasma) to reduce ATRs. Study design and methods All TTP patients who presented from April 2014 to February 2015 and experienced a moderate-severe ATR to untreated plasma with TPE were switched to S/D treated plasma (Octaplas) for their remaining procedures and included in the study. Patient records were retrospectively reviewed. Results The overall ATR rate per procedure decreased from 35.0% (95% CI = 15.4%-59.2%) with untreated plasma to 1.4% ([1/73] 95% CI = 0.0%-7.4%) with S/D treated plasma. The moderate-severe ATR rate decreased from 20.0% ([4/20] 95% CI = 5.7%-43.7%) with untreated plasma to 0.0% ([0/73] 95% CI = 0.0%-4.9%) with S/D treated plasma. The overall ATR rate per plasma unit decreased from 2.6% (95%CI = 1.0%-5.1%) with untreated plasma to 0.1% (95% CI = 0.0%-0.4%) with S/D treated plasma. No patients experienced VTE while receiving untreated plasma. Four patients experienced VTE events while receiving S/D treated plasma. All patients who experienced a VTE had additional risk factors for VTE. Conclusion S/D plasma has promise as an effective product to reduce the risk of ATRs in TTP patients. Given the high risk of ATR in TTP patients, consideration of S/D plasma instead of untreated plasma for TPE in these patients may be warranted, especially for patients with a history of moderate to severe ATR. More extensive studies are needed to confirm these findings.
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implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic Transfusion Reactions
Transfusion, 2018Co-Authors: Evan M Bloch, Aaron A R Tobian, Eric A Gehrie, Christi E Marshall, J S Boyd, Lisa Shifflett, Paul M NessAbstract:BACKGROUND Bacterial contamination of platelets remains a major Transfusion-associated risk despite long-standing safety measures in the United States. We evaluated an approach using secondary bacterial culture (SBC) to contend with residual risk of bacterial contamination. STUDY DESIGN AND METHODS Phased implementation of SBC was initiated in October 2016 for platelets (all apheresis collected) received at our institution from the blood donor center (Day 3 post collection). Platelet products were sampled aseptically (5 mL inoculated into an aerobic bottle [BacT/ALERT BPA, BioMerieux, Inc.]) by the blood bank staff upon receipt, using a sterile connection device and sampling kit. The platelet sample was inoculated into an aerobic blood culture bottle and incubated at 35°C for 3 days. The cost of SBC was calculated on the basis of consumables and labor costs at time of implementation. RESULTS In the 13 months following implementation (October 6, 2016, to November 30, 2017), 23,044/24,653 (93.47%) platelet products underwent SBC. A total of eight positive cultures were detected (incidence 1 in 2881 platelet products), seven of which were positive within 24 hours of SBC. Coagulase negative Staphyloccus spp. were identified in four cases. Five of the eight cases were probable true positive (repeat reactive) and interdicted (cost per averted case was US$77,935). The remaining three cases were indeterminate. No septic Transfusion Reactions were reported during the observation period. CONCLUSION We demonstrate the feasibility of SBC of apheresis platelets to mitigate bacterial risk. SBC is lower cost than alternative measures (e.g., pathogen reduction and point-of-release testing) and can be integrated into workflow at hospital Transfusion services.
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hypotensive Transfusion Reactions in the era of prestorage leukoreduction
Transfusion, 2015Co-Authors: Monica B Pagano, Paul M Ness, Olga S Chajewski, Karen E King, Aaron A R TobianAbstract:BACKGROUND Clinical characteristics of hypotensive Transfusion Reactions (HyTRs) have not been evaluated in the context of universal prestorage leukoreduction. STUDY DESIGN AND METHODS A retrospective review of medical records of patients with HyTRs during the years 2011 and 2012 was performed at two academic medical institutions. RESULTS Thirty-five patients with 35 HyTRs were identified, with an incidence of 1.33 per 10,000 Transfusions. Red blood cells (RBCs) were implicated in 21 (60.0%) Reactions and platelets (PLTs) and plasma (PL) in 11 (31.4%) and three (8.6%), respectively. The HyTR rate per blood component was 0.019% for PLTs, 0.015% for RBCs, and 0.006% for PL. Mean patient age was 65 years (range, 2 months-87 years), five (14.3%) were pediatric (<18 years), and 20 (57.1%) were male. The most frequent clinical settings associated with HyTRs were cardiac surgery (n = 13; 37.1%), hematology-oncology diseases (n = 11; 31.4%), and general surgery (n = 7; 20.0%). Extracorporeal circuits were used within 24 hours before the reaction in 16 patients (45.7%), including nine patients on cardiopulmonary bypass, four on dialysis or continuous venous-venous hemodialysis, and three on extracorporeal membrane oxygenation. Four patients (11.4%) received an angiotensin-converting enzyme inhibitor within 24 hours before the HyTR. Seventeen patients (48.6%) responded to stopping the Transfusion and supportive treatment. Thirteen patients (37.1%) had severe Reactions. No HyTR resulted in death. CONCLUSION In the absence of bedside leukoreduction filters, several medical situations are associated with HyTRs. The pathophysiology of HyTRs is yet to be defined. The US hemovigilance system allows for standardization of Transfusion Reactions, which facilitates their classification and study.
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the impact of platelet additive solution apheresis platelets on allergic Transfusion Reactions and corrected count increment cme
Transfusion, 2014Co-Authors: Aaron A R Tobian, Paul M Ness, Alice K Fuller, Daniel J Tisch, Kristin M Uglik, Prabhakar D Borge, Richard J Benjamin, Karen E KingAbstract:Background Allergic Transfusion reaction (ATR) incidence ranges from 1% to 3% of all Transfusions. We evaluated the impact of InterSol platelet additive solution (PAS) apheresis platelets (APs) on the incidence of ATRs and the postTransfusion platelet (PLT) increment. Study Design and Methods This retrospective study evaluated all ATRs among patients at a university hospital that maintained a mixed inventory of PAS APs and non-PAS APs (standard plasma-suspended PLTs). Corrected count increments (CCIs) were calculated for AP Transfusions of individuals who received both a PAS and a non-PAS AP Transfusion within a 7-day period. Hypothesis testing was performed with chi-square test for dichotomous variables and t tests for continuous variables. Results The incidence of ATRs among the non-PAS APs was 1.85% (72 ATRs/3884 Transfusions) and 1.01% (12 ATRs/1194 Transfusions) for PAS APs (risk ratio [RR], 0.54; 95% confidence interval [CI] = 0.30-0.99; p = 0.04). However, there was no difference in the incidence of febrile nonhemolytic Transfusion Reactions between non-PAS APs (incidence, 0.70%; 27/3884) compared to PAS APs (incidence, 0.59%; 7/1194; p = 0.69). Among 223 individuals with paired non-PAS and PAS AP Transfusions, the mean CCI at 1 to 4 hours after Transfusion was 4932 (95% CI, 4452-5412) for non-PAS APs and was lower for PAS APs (CCI, 3766; 95% CI, 3375-4158; p ≤ 0.001). However, there was no significant difference in mean CCI at 12 to 24 hours between non-PAS (CCI, 2135; 95% CI, 1696-2573) and PAS APs (CCI, 1745; 95% CI, 1272-2217; p = 0.14). Conclusions PAS APs substantially reduce the number of ATRs. CCIs for PAS APs were lower immediately after Transfusion, but not significantly different at 12 to 24 hours.
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scratching the surface of allergic Transfusion Reactions
Transfusion, 2013Co-Authors: William J Savage, Aaron A R Tobian, Jessica H Savage, Robert A Wood, John T Schroeder, Paul M NessAbstract:Allergic Transfusion Reactions (ATRs) are a spectrum of hypersensitivity Reactions that are the most common adverse reaction to platelets and plasma, occurring in up to 2% of Transfusions. Despite the ubiquity of these Reactions, little is known about their mechanism. In a small subset of severe Reactions, specific antibody has been implicated as causal, although this mechanism does not explain all ATRs. Evidence suggests that donor, product, and recipient factors are involved, and it is possible that many ATRs are multifactorial. Further understanding of the mechanisms of ATRs is necessary so that rationally designed and cost-effective prevention measures can be developed.
Sandra Ramirezarcos - One of the best experts on this subject based on the ideXlab platform.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
Michael R. Jacobs - One of the best experts on this subject based on the ideXlab platform.
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detection of septic Transfusion Reactions to platelet Transfusions by active and passive surveillance
Blood, 2016Co-Authors: Hong Hong, Wenbin Xiao, Hillard M Lazarus, Caryn E Good, Robert W Maitta, Michael R. JacobsAbstract:Septic Transfusion Reactions (STRs) resulting from Transfusion of bacterially contaminated platelets are a major hazard of platelet Transfusion despite recent interventions. Active and passive surveillance for bacterially contaminated platelets was performed over 7 years (2007-2013) by culture of platelet aliquots at time of Transfusion and review of reported Transfusion Reactions. All platelet units had been cultured 24 hours after collection and released as negative. Five sets of STR criteria were evaluated, including recent AABB criteria; sensitivity and specificity of these criteria, as well as detection by active and passive surveillance, were determined. Twenty of 51,440 platelet units transfused (0.004%; 389 per million) were bacterially contaminated by active surveillance and resulted in 5 STRs occurring 9 to 24 hours postTransfusion; none of these STRs had been reported by passive surveillance. STR occurred only in neutropenic patients transfused with high bacterial loads. A total of 284 Transfusion Reactions (0.55%) were reported by passive surveillance. None of these patients had received contaminated platelets. However, 6 to 93 (2.1%-32.7%) of these 284 Reactions met 1 or more STR criteria, and sensitivity of STR criteria varied from 5.1% to 45.5%. These results document the continued occurrence of bacterial contamination of platelets resulting in STR in neutropenic patients, failure of passive surveillance to detect STR, and lack of specificity of STR criteria. These findings highlight the limitations of reported national STR data based on passive surveillance and the need to implement further measures to address this problem such as secondary testing or use of pathogen reduction technologies.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
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relationship between bacterial load species virulence and Transfusion reaction with Transfusion of bacterially contaminated platelets
Clinical Infectious Diseases, 2008Co-Authors: Michael R. Jacobs, Hillard M Lazarus, Caryn E Good, Roslyn YomtovianAbstract:BACKGROUND Bacterial contamination is currently the major infectious hazard of platelet Transfusion, but associations between bacterial species and quantity and Transfusion Reactions have not been characterized. METHODS Patients receiving platelets from July 1991 through December 2006 were observed using active surveillance by quantitative culture of platelets at the time of issue or passive surveillance by investigation of clinical Reactions in patients and culture of implicated units. Patient Reactions were classified by type and severity and were correlated with bacterial species and number. Endotoxin content of gram-negative contaminants was determined by limulus lysate assay. RESULTS Fifty-two bacterially contaminated platelet units were detected (50 by active and 2 by passive surveillance). Rates of bacterial contamination and septic Transfusion Reactions were 32.0-fold and 10.6-fold higher, respectively, as determined by active versus passive surveillance (P or =10(5) colony-forming units/mL and higher bacterial virulence. A detection method with a 10(3) colony-forming units/mL threshold would detect >90% of contaminants. CONCLUSIONS Active surveillance detected 32-fold more bacterially contaminated platelet units and 10.6-fold more septic Reactions than did passive surveillance, and virulent species and bacterial counts of > or =10(5) colony-forming units/mL were associated with more-severe Transfusion Reactions. Improved detection methods or use of pathogen inactivation technology are needed to eliminate this problem.
Valerie Grecostewart - One of the best experts on this subject based on the ideXlab platform.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.
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serratia marcescens strains implicated in adverse Transfusion Reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture
Vox Sanguinis, 2012Co-Authors: Valerie Grecostewart, Christopher J Parr, Roslyn Yomtovian, Miloslav Kalab, E. E. Brown, Michael R. Jacobs, Sandra RamirezarcosAbstract:Background and Objectives Serratia marcescens is a Gram-negative bacterium that has been implicated in adverse Transfusion Reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Materials and Methods Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria–Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. Results All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with Transfusion Reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P < 0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. Conclusion S. marcescens strains associated with Transfusion Reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.