Blood for transfusion is a potential source of infection by a variety of known and unknown transmissible agents. Over the last 20 years, astounding reductions in the risk of viral infection via allogeneic blood have been achieved. As a result of this success, bacterial contamination of blood products has emerged as the greatest residual source of transfusion-transmitted disease. This paper summarizes the current status of detection, prevention, and elimination of bacteria in blood products for transfusion.
"It is clear that removal of harmful antigens would lead to improvement of patients’ health; thereafter, the general performance of the patients would improve and conventional therapies would work more efficiently. Examples of such rehabilitations are as follow: 1) bacterial sepsis not responsive to conventional antibiotic therapies, eg, coagulase-negative Staphylococcus strain and Serratia liquefaciens, which may lead to death in less than 25 hours;21 2) viral blood infections, eg, viral hepatitis B and C and human immunodeficiency virus; 3) botulism; 4) tetanus antigens and related toxins; 5) blood fungal infections, eg, septicemia with Candida albicans; 6) biological wars in which sepsis and microbial blood invasions occur; 7) in cases of Alzheimer’s and Parkinson’s diseases, if their causative or specific antigens are determined, regular or occasional removal of such antigens from the blood and/or cerebrospinal fluid may improve the patient’s health and slow down the disease progression; and 8) to enhance blood transfusion safety regarding undesirable residues of some antigens, such columns may be used as prophylactic measures prior to transfusions of blood derivatives. Each of the proposed approaches should be evaluated for their applicability; however, optimization studies in animals should always pave the way for future human applications. "
[Show abstract][Hide abstract] ABSTRACT: The prospective removal of snake venoms from the blood of snake-bitten patients is discussed here. Opportune neutralization of killer antigens from the blood of poisoned victims is a vital treatment step. Delays may lead to death, or cripple the patient permanently. The present procedure describes the elimination of venom antigens of a wide range of snakes from the blood of such patients. Compared to conventional treatments, the treatment is administrable in the lack of proper antivenoms, expected to be more effective with less side effects, covers a vast range of snake venoms, minimizes contact of venoms with internal tissues and organs, is applicable in patients sensitive to serum injections, has a high chance of effectiveness because there is no need to identity the snake involved to administer its specific antibody, and is capable of universal application. The principal component to this approach is a "polyvalent venom antibody column" (PVAC), which selectively traps venom antigens from blood in an extracorporeal circuit while detoxified blood returns back to the patient's body. The PVAC is intended for removal of numerous snake venom antigens in a relatively simple procedure. Detoxification is performed under the supervision of trained personnel using simple blood-circulating machines in which blood circulates from patient to PVAC and back to the patient aseptically. The device acts as a biological filter that selectively immobilizes harmful venom antigens from poisoned blood. For effective neutralization, the PVAC provides a large contact surface area with blood. The PVAC's reactive sites would consist of carbon nanotubes, on which a vast spectra of venoms' antibodies are bonded to. In this extracorporeal detoxification process, nocent antigens conjugate with their antibodies and become immobilized, and are eliminated from the poisoned patient blood. Detoxification resuscitation is expected to take 2-3 hours, when the titers of venom antigens in the blood reach harmless levels, as confirmed by sampling of the blood and appropriate serological evaluations. If conventional antivenoms do not cover the entire spectrum of venom antigens in blood, rehabilitation would be a matter of a longer period; whilst the PVAC covers the widest range of antibodies to remove the broadest range of venom antigens, the rehabilitation period would be shorter since venom antigens have been removed from the body in a few hours duration. PVACs are to be biotechnologically engineered against a wide spectra of antigens present in the venoms of the dominant poisonous snakes for a defined geographical zone; ie, a country, part of a continent, or an entire continent. As a polyvalent column, the PVAC bears a sufficient amount of venom antibodies of all snakes that pose a threat in the region. PVAC treatment would have high applicability in cases where the patient is unconscious and/or the snake identity is not clear for administration of related antivenom medication. For opportune administration, research on the use of PVACs in emergency ambulances should receive special attention. Starting in situ detoxification, such ambulances would provide more efficient resuscitations to envenomed patients.
Drug Design, Development and Therapy 06/2014; 8:819-25. DOI:10.2147/DDDT.S65395 · 3.03 Impact Factor
"The most frequently isolated bacteria were S. aureus followed by Coagulase negative Staphylococci, E. coli and Klebsiella species. Similar findings were reported elsewhere [14, 16, 18, 22, 27, 30, 31]. "
[Show abstract][Hide abstract] ABSTRACT: Background. Transfusion associated bacterial infection has remained more frequent with a sever risk of morbidity and mortality. This study assessed the bacteriological safety of blood collected for transfusion. Method. A cross-sectional study was conducted at University of Gondar hospital blood bank from December 2011 to June 2012. Bacterial isolation, identification, and antimicrobial susceptibility tests were done as per the standard procedure. Chi-square test and P value were used to assess associations between risk factors and the bacterial isolation rate. Results. Twenty-one (15.33%) blood units were found contaminated with bacteria, and 95.24% contamination was due to external sources. The commonly isolated bacteria were Staphylococcus aureus, Coagulase negative Staphylococci, Escherichia coli, Klebsiella species, Streptococci species, Enterobacter species, and Citrobacter species. All of the bacteria isolated were 100% sensitive to Gentamicin, Chloramphenicol, Amoxicillin, and Doxycycline. Multiple antimicrobial resistances were observed in 66.7% of the isolates. Not using glove by phlebotomist, touching disinfected phlebotomy site and double puncture at the same hand or both hands of a donor were found to be risk factors for bacterial contamination. Conclusion. Bacterial contamination of blood to be transfused is a common problem in the hospital. So attention should be given to activities performed at the blood bank for safe transfusion practices.
"Testing methods can be divided into culture methods and rapid detection methods. Most of the countries that implemented routine bacterial screening use culture methods (BacT/Alert or Pall eBDS) (Brecher et al., 2005; Dunne et al., 2005; Fang et al., 2005; Benjamin & Wagner, 2007; Ezuki et al., 2007; Nussbaumer et al., 2007; Benjamin et al., 2008; Su et al., 2008). Samples are usually collected 24 h after blood donation. "
[Show abstract][Hide abstract] ABSTRACT: The residual risk for bacterial contamination in blood components especially in platelets is one to two orders of magnitude higher than for transfusion relevant viral infections. The majority of all bacterial transmitted fatalities occurred at the end of platelet shelf life. Therefore, the maximum shelf life of platelet concentrates (PC) was reduced to 4 days after blood donation in Germany in 2008.
A new continuous non-invasive bacterial detection method was developed by O(2) measurements in the platelet fluids and tested with 10 transfusion relevant bacteria species.
The bacterial concentration at the time point of a positive signal of PreSense O(2) ranged between 10(2) and 10(5) CFU mL(-1) . Harmful transfusion-transmitted bacterial infection would have probably been prevented by this novel technology. Only strict anaerobic bacteria strains like Clostridium perfringens were not detected within the study period of 72 h.
The described non-invasive bacterial detection method represents a new approach to prevent transmission of bacterial infection in platelets. The method is characterised by the advantage that all investigations can be performed until right up to the time of transfusion, and therefore, reduce the risk for sample errors to a minimum.
Transfusion Medicine 03/2012; 22(3):211-6. DOI:10.1111/j.1365-3148.2012.01146.x · 1.65 Impact Factor
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