Transfusion-associated Serratia marcescens infection: studies of the mechanism of action.
The growth of two strains of Serratia marcescens in blood components was tested in this study. One of the strains had been implicated in the epidemic of transfusion-associated sepsis experienced in Denmark and Sweden in 1991. In whole blood with a final concentration of 100 colony-forming units per mL of S. marcescens, there was an immediate reduction of more than 95 percent of colony-forming units, but no reduction of the bacterial concentration if the blood had been white cell-reduced before inoculation. This is interpreted as an effect due to phagocytosis by white cells and as a lack of bactericidal effect of the plasma. A reduction to 10 percent of the original concentration, observed if the blood had a nominal content of white cells, was most likely due to phagocytosis. White cell reduction by filtration after inoculation further reduced the bacterial concentration of one of the strains tested, but, after a 1-week lag phase, growth accelerated to high concentrations by 6 weeks. In platelet-rich plasma prepared from S. marcescens-inoculated units, abundant growth was found after 24 hours, increasing to very high concentrations (10(12) colony-forming units/mL) during 10-day storage at 22 +/- 2 degrees C. Keeping the whole blood at ambient temperature for 20 hours before preparation of platelet-rich plasma caused only temporary reduction of bacterial concentration in the S. marcescens experiments, but resulted in a complete absence of bacteria in the platelet-rich plasma for 10 days in control experiments performed with Staphylococcus epidermidis.(ABSTRACT TRUNCATED AT 250 WORDS)
Gong
J
J
Department of Clinical Immunology and Transfusion Medicine, University Hospital, Uppsala, Sweden.
Högman
C F
CF
Hambraeus
A
A
Johansson
C S
CS
Eriksson
L
L
D001792:Blood Platelets / Q000382:microbiology; D004912:Erythrocytes / Q000382:microbiology; D006801:Humans; D016868:Serratia Infections / Q000209:etiology*; D012706:Serratia marcescens / Q000254:growth & development; D013211:Staphylococcus aureus / Q000254:growth & development; D013212:Staphylococcus epidermidis / Q000254:growth & development; D065227:Transfusion Reaction