Bacteriological analysis of platelets and cases of septic reactions associated with transfusion of contaminated samples.

INTRODUCTION: For years, platelet transfusion therapy has been playing an important role in controlling patients with hematological and oncological diseases. However, platelet transfusion represents a serious risk for bacterial sepsis. This study aimed to verify the bacterial contamination index in platelet concentrates (PCs) obtained from the Blood Center of the State of Rio Grande do Sul (HEMORGS). METHODS: All 612 samples of PCs from HEMORGS were analyzed in August 2009 and January 2010. We used a qualitative methodology which was modified manually in order to detect bacterial contamination. The patients who received the platelet units with confirmed positive cultures had their medical records analyzed. After the prospective study, a retrospective analysis of the samples of PCs checked by the bacteriological control from HEMORGS since its foundation (2008) until 2010 was made. RESULTS: Four hundred and eighty samples (10 monthly samples of plateletpheresis and 10 of whole blood-derived platelets) were analyzed in order to compare the contamination index for both studies. Of 1092 samples, 15 were found to be contaminated (6 of retrospective analysis and 9 of prospective). In prospective study, isolated microorganisms were nine Staphylococcus epidermidis, but in retrospective two Staphylococcus sp., two glucose non-fermenting gram negative bacilli, one Streptococcus sp. and one Proteus mirabilis. We report 3 feasible cases of bacterial sepsis associated with the transfusion of CPs analyzed by prospective study. CONCLUSION: Bacterial sepsis associated with platelet transfusion is today the most frequent infectious complication of transfusion medicine. Although complex, it is important to recognize transfusion sepsis in patients to reduce morbidity and mortality.

N-Acetylcysteine prevents baker's-yeast-induced inflammation and fever.

OBJECTIVE AND DESIGN: To investigate whether N-acetylcysteine (NAC) alters baker's-yeast-induced fever and inflammation. MATERIAL OR SUBJECTS: Male Wistar rats (26-28 days old) injected with baker's yeast (135 mg/kg, intraperitoneal) or prostaglandin E(2) (300 ng/100 µL, intrathecal). TREATMENT: Rats were injected with NAC (500 mg/kg, subcutaneous, or 50 µg/100 µL, intrathecal) 1 h before, or 2 h after, pyrogen injection. METHODS: Rectal temperature changes induced by baker's yeast, PGE(2) and NAC were followed up over time. Four hours after baker's yeast injection, total leukocytes, protein, interleukin (IL)-1ß, tumor necrosis factor (TNF)-α and nonprotein thiol content were assessed in peritoneal lavage and hypothalamus. RESULTS: Systemic administration of NAC decreased leukocytes, protein, IL-1ß and TNF-α levels in peritoneal lavage, and decreased IL-1ß levels in the hypothalamus. The central administration of NAC prevented baker's-yeast-induced fever, but did not alter the febrile response elicited by prostaglandin E(2). CONCLUSION: These results suggest an anti-inflammatory and antipyretic role for NAC in yeast-induced peritonitis.

[Bacterial contamination on platelet concentrates: identification, antimicrobial susceptibility profile and transfusion-related sepsis]. / Contaminação bacteriana em concentrados plaquetários: identificação, perfil de sensibilidade aos antimicrobianos e sepse associada à transfusão.

INTRODUCTION: Bacterial sepsis associated with the transfusion of platelet concentrates (PCs) results in serious clinical implications for patients. Given these implications, certain procedures have been integrated into the preparation and quality control of blood components to reduce the risk of bacterial contamination. This article describes the prevalence of bacterial contamination on transfused PCs, the bacterial spectrum detected and their antimicrobial susceptibility profile and transfusion reactions in receptors. METHODS: A total of 292 PCs (278 random and 14 per apheresis) from the Blood Center of the State of Rio Grande do Sul (HEMORGS), located in the city of Santa Maria, were tested. Quantities of 100 µL and 200 µL were collected from platelet bag tubing and seeded using two methodologies. RESULTS: Using the qualitative methodology, bacteria were isolated in five units (1.7%; 5/292), while only one was isolated using the quantitative methodology. Staphylococcus epidermidis was the microorganism identified in all samples. Two patients died of transfusion-related sepsis. CONCLUSIONS: Bacterial contamination due to PC transfusion is considered a major public health problem due to its association with high rates of morbidity and mortality. In this study only gram-positive microorganisms were isolated and none of the samples obtained by apheresis presented contamination.

Contaminação bacteriana em concentrados plaquetários: identificação, perfil de sensibilidade aos antimicrobianos e sepse associada à transfusão / Bacterial contamination on platelet concentrates: identification, antimicrobial susceptibility profile and transfusion-related sepsis

INTRODUÇÃO: Devido à sepse bacteriana associada à transfusão de concentrados plaquetários (CPs) ter sérias consequências clínicas para os pacientes, alguns procedimentos têm sido incorporados na preparação e no controle de qualidade dos componentes sanguíneos para reduzir o risco da contaminação bacteriana. Este artigo descreve a prevalência da contaminação bacteriana dos CPs que foram transfundidos, o espectro bacteriano detectado com seu perfil de sensibilidade aos antimicrobianos e as reações transfusionais nos receptores. MÉTODOS: Um total de 292 CPs (278 randômicos e 14 por aférese), proveniente do Hemocentro do Estado do Rio Grande do Sul (HEMORGS) de Santa Maria foi testado. As quantidades de 100μL e 200μL foram coletadas da porção tubular da bolsa de plaquetas e semeadas utilizando dois tipos de metodologias. RESULTADOS: Em cinco unidades(1,7 por cento; 5/292) foram isoladas bactérias pela metodologia qualitativa e apenas uma pela quantitativa. Staphylococcus epidermidis foi o microrganismo identificado em todas as amostras. Dois pacientes apresentaram sepse associada à transfusão com desfecho fatal. CONCLUSÕES: A contaminação bacteriana pelas transfusões de CPs constitui-se num importante problema de saúde pública devido a sua associação com altas taxas de morbidade e mortalidade. Neste estudo, somente microrganismos gram-positivos foram isolados sendo que nenhuma amostra obtida por aférese apresentou contaminação.

INTRODUCTION: Bacterial sepsis associated with the transfusion of platelet concentrates (PCs) results in serious clinical implications for patients. Given these implications, certain procedures have been integrated into the preparation and quality control of blood components to reduce the risk of bacterial contamination. This article describes the prevalence of bacterial contamination on transfused PCs, the bacterial spectrum detected and their antimicrobial susceptibility profile and transfusion reactions in receptors. METHODS: A total of 292 PCs (278 random and 14 per apheresis) from the Blood Center of the State of Rio Grande do Sul (HEMORGS), located in the city of Santa Maria, were tested. Quantities of 100μL and 200μL were collected from platelet bag tubing and seeded using two methodologies. RESULTS: Using the qualitative methodology, bacteria were isolated in five units (1.7 percent; 5/292), while only one was isolated using the quantitative methodology. Staphylococcus epidermidis was the microorganism identified in all samples. Two patients died of transfusion-related sepsis. CONCLUSIONS: Bacterial contamination due to PC transfusion is considered a major public health problem due to its association with high rates of morbidity and mortality. In this study only gram-positive microorganisms were isolated and none of the samples obtained by apheresis presented contamination.

Diacerein decreases TNF-alpha and IL-1beta levels in peritoneal fluid and prevents Baker's yeast-induced fever in young rats.

OBJECTIVE: To investigate the effect of diacerein, an anti-inflammatory drug, on body temperature and protocols of fever induction in male Wistar rats. METHODS: The effect of diacerein (5.0 mg/kg, s.c.) on rectal temperature (T (R)) changes induced by Baker's yeast (0.135 g/kg, i.p.) and PGE(2) (10 ng/animal, i.t.) was evaluated. T (R) changes were recorded over time. The leukocyte count and TNF-alpha and IL-1beta content were evaluated in the peritoneal fluid by means of optical microscopy and enzyme immunoassay (ELISA kits), respectively. RESULTS: The administration of diacerein to febrile animals attenuated Baker's yeast-induced fever but did not alter prostaglandin E(2)-induced fever. Diacerein prevented the development of Baker's yeast-induced fever and significantly attenuated the increase in peritoneal leukocytes and decreased IL-1beta and TNF-alpha levels in peritoneal fluid. CONCLUSIONS: These data suggest that diacerein partially protects against Baker's yeast-induced fever and peritoneal leukocyte migration, and indicate that this effect appears to be due to inhibition of release of cytokines (such as TNF-alpha and IL-1beta).

Hypothermic and antipyretic effects of 3-methyl- and 3-phenyl-5-hydroxy-5-trichloromethyl-4,5-dihydro-1H-pyrazole-1-carboxyamides in mice.

The effect of novel pyrazolines, 3-methyl-5-hydroxy-5-trichloromethyl-4,5-dihydro-1H-pyrazole-1-carboxyamide (MPCA) and 3-phenyl-5-hydroxy-5-trichloromethyl-4,5-dihydro-1H-pyrazole-1-carboxyamide (PPCA) on body temperature and endotoxin-induced fever was investigated in mice. The subcutaneous (s.c.) administration of 1.5 mmol/kg dipyrone, MPCA or PPCA and the intracerebroventricular (i.c.v.) administration of 225 nmol dipyrone reduced basal rectal temperature. Intracerebroventricular administration of 225 nmol MPCA or PPCA did not alter basal rectal temperature. The administration of 0.15 mmol/kg (s.c.) or 25 nmol (5 microl) dipyrone (i.c.v.), MPCA or PPCA had no effect on basal rectal temperature, but reversed lipopolysaccharide-induced fever. These results suggest that MPCA and PPCA cause antipyresis, which is similar to that caused by dipyrone, and may be useful antipyretic agents.