title: Bicarbonate inhibits the growth of Staphylococcus epidermidis in platelet concentrates by lowering the level of non-transferrin-bound iron.
abstract: BACKGROUND
  Platelet concentrates (PCs) contain non-transferrin-bound iron (NTBI) owing to the displacement of iron from plasma-derived transferrin by citrate. NTBI in the PC medium supports the growth of Staphylococcus epidermidis. The possibilities of lowering the level of NTBI have been studied with the aim to inhibit the growth of S. epidermidis in the PC medium.
  
  
  METHODS
  NTBI in PC supernatants was determined by a chelation method and by the bleomycin-detectable iron assay. Iron binding by transferrin was determined by spectrophotometry. The growth of inoculated S. epidermidis in PC supernatants was monitored by optical density and determination of viable counts.
  
  
  RESULTS
  Bicarbonate enhanced in a dose-dependent manner transferrin iron binding in citrate-containing solutions, including citrated plasma and PAS-II. The use of a modified anticoagulant supplemented with bicarbonate effectively lowered the level of NTBI and inhibited bacterial growth in citrated plasma. Supplementation of bicarbonate to the additive solution to increase the ratio of bicarbonate to citrate in a reconstituted PC medium further inhibited bacterial growth. Maintenance of stable pH and bicarbonate level in the reconstituted medium necessitated storage under 5 percent CO(2).
  
  
  CONCLUSIONS
  The relatively low bicarbonate level in PC medium promotes iron displacement by citrate from plasma-derived transferrin. The appearance of NTBI can be decreased and iron-dependent bacterial growth can be inhibited by increasing bicarbonate level in citrated plasma and PC medium. To achieve the same beneficial effect in blood banking, other more practical ways to bind NTBI in a harmless form should be developed.
authors.affiliation: Finnish Red Cross Blood Service, Helsinki.
authors.forename: Sanna
authors.initials: S
authors.lastname: Matinaho
authors.forename: Paulina
authors.initials: P
authors.lastname: Karhumäki
authors.forename: Jaakko
authors.initials: J
authors.lastname: Parkkinen
mesh_terms: D001639:Bicarbonates / Q000008:administration & dosage / Q000494:pharmacology*; D001792:Blood Platelets / Q000378:metabolism* / Q000382:microbiology*; D001793:Blood Preservation; D002951:Citrates / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007501:Iron / Q000037:antagonists & inhibitors / Q000378:metabolism*; D012996:Solutions; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development*; D014168:Transferrin / Q000378:metabolism*
chemical_list: D001639:Bicarbonates; D002951:Citrates; D012996:Solutions; D014168:Transferrin; D007501:Iron