혈소판제제의 세균오염 검출 선별검사를 위한 자동요유세포분석기의 평가
Evaluation of an Automated Urine Flow Cytometer for Screening of Bacterial Contamination in Platelet Concentrates
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배경: 혈소판제제의 세균오염은 수혈에 의한 감염의 주요 위험인자이다. 혈소판제제의 세균오염을 검출하기 위한 여러 가지 방법들이 소개되었고, 또한 개발 중에 있다. 저자들은 혈소판제제의 세균오염 검출을 위한 선별검사로서 요유세포분석기인 Sysmex UF-1000i (Sysmex Medical Electronics Co, Japan)의 유용성을 평가해보았다. 방법: 여러 가지 농도의 혈소판 균액(Staphylococcus aureus and Escherichia coli)을 제조하여 요유세포분석기를 이용해 세균수를측정하였다. 모든 검체는 혈소판에 의한 혼탁이 초래할 수 있는 간섭을 예방하기 위해 요유세포분석기를 사용하기 전 생리식염수를이용해 1:10배수로 희석한 뒤 분석을 시행하였다. 결과: 높은 수의 세균(105 CFU/mL)이 포함된 혈소판 균액에서는요유세포분석기를 사용해 세균을 정량 분석했을 때 표준균액을섞지 않은 혈소판제제에 비해 유의하게 높은 세균 수가 측정되었다. 그러나, 104 CFU/mL 농도 이하의 혈소판균액에서는 표준균액을 섞지 않은 혈소판제제와 비교했을 때 세균 수의 유의한 차이가관찰되지 않았다. 결론: 자동요유세포분석기는 사용하기 쉽고 5분 이내에 검사결과를 얻을 수 있으며, 혈소판제제 내의 약 105 CFU/mL 농도의 세균을검출할 수 있었다. 이 방법의 유용성을 평가하기 위해 추가적인 검증 실험이 더 필요할 것으로 생각된다.
Abstract
Background: Bacterial contamination of blood products, particularly of platelet concentrates (PCs), is a major risk factor for infections caused by blood transfusion. Various methods for the detection of bacterial contamination in PCs are available or are under investigation. We evaluated the usefulness of the Sysmex UF-1000i urine flow cytometer (Sysmex Medical Electronics Co, Japan) for screening of bacterial contamination in PCs. Methods: The PCs were inoculated with various concentrations of bacteria (Staphylococcus aureus and Escherichia coli) and were analyzed with the urine flow cytometer for bacterial counts. All the samples were diluted with normal saline (1:10) before flow cytometric analysis in order to prevent interference by the turbidity due to platelets. Results: For PCs inoculated with a high number (colony forming unit, CFU) of bacteria (105 CFU/mL), the bacterial counts were significantly higher than those for uninoculated PCs analyzed by the urine flow cytometer. However, bacterial counts for PCs inoculated with bacteria of 104 CFU/mL or less and those for uninoculated PCs were not significantly different. Conclusions: An automated urine flow cytometer evaluated in this study is easy to use, and the procedure is completed in less than 5 min. Moreover, the urine flow cytometer could detect approximately 105 CFU/mL of bacteria in PCs. Further validation studies are needed to assess the usefulness of this method for screening of bacterial contamination in PCs.
참고문헌 (20)
- 권소영, "혈소판제제 세균오염 검출방법 비교 평가", 대한수혈학회지, 22(2), pp.99~109 (2011), 대한수혈학회
- Hillyer CD, "Bacterial contamination of blood components: risks, strategies, and regulation: joint ASH and AABB educational session in transfusion medicine", Hematology Am Soc Hematol Educ Program, pp.575~589 (2003)
- Blajchman MA, "Improving the bacteriological safety of platelet transfusions", Transfus Med Rev, 18, pp.11~24 (2004)
- Park KU, "Long term prospects for the blood supply and demand", Korean J Blood Transfus, 17, pp.1~10 (2006)
- 이혁민, "혈소판 제제에서 세균 오염 검출을 위한 방법의 민감도 비교", 대한수혈학회지, 20(1), pp.32~39 (2009), 대한수혈학회
- "Blood service statistics. Korean Red Cross", 41~ (2011)
- Kuehnert MJ, "Transfusion-transmitted bacterial infection in the United States, 1998 through 2000", Transfusion, 41, pp.1493~1499 (2001)
- Pietersz RN, "Detection of bacterial contamination of platelet concentrates", Vox Sang, 93, pp.260~277 (2007)
- Liu HW, "Reduction of platelet transfusion-associated sepsis by short-term bacterial culture", Vox Sang, 77, pp.1~5 (1999)
- Ramírez-Arcos S, "Canadian experience with detection of bacterial contamination in apheresis platelets", Transfusion, 47, pp.421~429 (2007)
- "Blood service statistics. Korean Red Cross", 78~ (2010)
- Dreier J, "Novel flow cytometry-based screening for bacterial contamination of donor platelet preparations compared with other rapid screening methods", Clin Chem, 55, pp.1492~1502 (2009)
- Munksgaard L, "Detection of bacterial contamination of platelet components: six years’ experience with the BacT", ALERT system, 2004, pp.44, 1163~1173
- Brecher ME, "Evaluation of a new generation of plastic culture bottles with an automated microbial detection system for nine common contaminating organisms found in PLT components", Transfusion, 44, pp.359~363 (2004)
- Wagner SJ, "Comparison of bacteria growth in single and pooled platelet concentrates after deliberate inoculation and storage", Transfusion, 35, pp.298~302 (1995)
- Goodnough LT, "Transfusion medicine: looking to the future", Lancet, 361, pp.161~169 (2003)
- Jolkkonen S, "Screening of urine samples by flow cytometry reduces the need for culture", J Clin Microbiol, 48, pp.3117~3121 (2010)
- Hu X, "Evaluation of the Sysmex UF-1000i urine analyzer as a screening test to reduce the need for urine cultures for urinary tract infection", Labmedicine, 41, pp.349~352 (2010)
- Manoni F, "Cutoff values for bacteria and leukocytes for urine flow cytometer Sysmex UF-1000i in urinary tract infections", Diagn Microbiol Infect Dis, 65, pp.103~107 (2009)
- Jacobs MR, "Relationship between bacterial load, species virulence, and transfusion reaction with transfusion of bacterially contaminated platelets", Clin Infect Dis, 46, pp.1214~1220 (2008)