title: Rapid identification of bacterially contaminated platelets using reagent strips: glucose and pH analysis as markers of bacterial metabolism.
abstract: BACKGROUND
  One in every 1000 units of platelets is bacterially contaminated, which puts patients at risk for transfusion-associated sepsis and death. However, there is currently no screening test in place to detect contaminated units. The use of commercially available multiple-reagent urine dipsticks for this purpose was evaluated.
  
  
  METHODS
  Platelet concentrates were inoculated with either sterile saline or suspensions of Staphylococcus aureus, Staphylococcus epidermidis, Bacillus cereus, Klebsiella pneumoniae, or Serratia marcescens to a final concentration of 50 colony-forming units (CFU) per mL. The platelets were analyzed daily by the use of multiple-reagent strips, quantitative culture, and glucometry.
  
  
  RESULTS
  B cereus grew rapidly, reaching 10(7) CFU per mL 1 day after inoculation, while S. epidermidis grew slowly, achieving similar concentration 4 to 6 days after inoculation. Two of 10 dipstick reagents, glucose and pH, proved useful in detecting bacteria. Both were lower in bacterially contaminated units than in controls. Glucose data obtained from automated analyzers validated the dipstick data. All organisms were detected at concentrations > or = 10(7) CFU per mL, and S. aureus and K. pneumoniae were detected in the range of 10(3) to 10(5) CFU per mL.
  
  
  CONCLUSIONS
  The multiple-reagent test used had a sensitivity and specificity of 95 percent (> or = 10(7) CFU/mL) and 98 to 100 percent, respectively. These data indicate that urine dipsticks can be used to rapidly and inexpensively detect bacterial contamination in platelet concentrates, which potentially will reduce morbidity and mortality at minimal cost.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Burstain
authors.forename: M E
authors.initials: ME
authors.lastname: Brecher
authors.forename: K
authors.initials: K
authors.lastname: Workman
authors.forename: M
authors.initials: M
authors.lastname: Foster
authors.forename: G H
authors.initials: GH
authors.lastname: Faber
authors.forename: D
authors.initials: D
authors.lastname: Mair
mesh_terms: D001409:Bacillus cereus / Q000254:growth & development; D016470:Bacteremia / Q000175:diagnosis / Q000209:etiology*; D001419:Bacteria / Q000378:metabolism; D001424:Bacterial Infections / Q000652:urine; D015415:Biomarkers / Q000032:analysis; D001792:Blood Platelets / Q000382:microbiology*; D015169:Colony Count, Microbial; D005947:Glucose / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007711:Klebsiella pneumoniae / Q000254:growth & development; D011934:Reagent Strips; D013212:Staphylococcus epidermidis / Q000254:growth & development; D065227:Transfusion Reaction; D014556:Urine / Q000382:microbiology
chemical_list: D015415:Biomarkers; D011934:Reagent Strips; D005947:Glucose