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PRP as a New Approach to Prevent Infection: Preparation and In vitro Antimicrobial Properties of PRP
Published on: April 9, 2013
Microbial contamination risks and clinical safety in platelet-rich plasma therapy and evaluation of rapid microbial
Anna Arita1, Yoshitomo Saita2, Naho Fujiwara3
1Medical Technology Innovation Center, Juntendo University, A-Bld, 3F, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Introduction:
Platelet-rich plasma (PRP) is widely used for pain relief, wound healing, and so on. However, recent reports have documented cases of infections occurring after PRP therapy. In this study, we aimed to examine potential microbial contamination risks associated with PRP therapy and evaluate rapid microbial detection methods suitable for clinical use.
Methods:
We assessed the risk of microbial contamination during blood collection, PRP preparation, and sterility testing. To evaluate suitable detection methods, we compared the microbial detection sensitivities of flow cytometry (FCM) and polymerase chain reaction (PCR) for identifying microbial contamination in PRP. For this purpose, PRP samples were inoculated with Staphylococcus aureus, Streptococcus spp., Cutibacterium acnes, Micrococcus spp., Bacillus subtilis, and Candida albicans.
Results:
Following skin disinfection, microbial colonies were detected at the venipuncture site in six out of ten patients. Environmental monitoring identified airborne microbial colonies in two out of three anonymous PRP preparation facilities. Sterility tests revealed negative results for all 85 residual PRP and 15 platelet-poor plasma (PPP) cases. FCM sensitivity for microbial detection in PRP was effective at a concentration of 102-103 colony forming units (cfu)/mL or higher. While C. albicans could not be detected separately from non-specific PRP signals using FCM, it was detectable in PPP at ≥102 cfu/mL. PCR sensitivity for microbial detection was excellent when analyzing pure microbial suspensions, however, it yielded a high rate of false-negative and false-positive results when PRP samples contained certain microbial strains.
Conclusion:
The risks of microbial contamination were identified during both venipuncture and PRP production. To reduce these risks, it may be necessary to improve disinfection protocols for venipuncture sites and blood collection methods, implementing appropriate facility-specific measures. Although requiring further detection sensitivity improvements, FCM is a promising method for detecting viable bacteria in PRP. Given that microbial contamination cannot be completely eliminated, clinicians providing PRP therapy should remain alert to the potential for postoperative infections and ensure appropriate follow-up protocols are established.
Insights
Microbial contamination risks exist during platelet-rich plasma (PRP) collection and preparation. Flow cytometry shows promise for detecting bacteria in PRP, but improved methods are needed to ensure patient safety and prevent infections.
Area of Science:
- Microbiology
- Biotechnology
- Clinical Diagnostics
Background:
- Platelet-rich plasma (PRP) is increasingly used for therapeutic purposes, including pain relief and wound healing.
- Recent reports highlight concerns regarding post-therapy infections, necessitating an investigation into microbial contamination risks associated with PRP.
Purpose of the Study:
- To assess microbial contamination risks during blood collection and PRP preparation.
- To evaluate the efficacy of flow cytometry (FCM) and polymerase chain reaction (PCR) as rapid detection methods for microbial contaminants in PRP.
Main Methods:
- Microbial contamination risks were assessed at venipuncture sites and in PRP preparation facilities.
- The sensitivity of FCM and PCR for detecting inoculated microorganisms (e.g., *Staphylococcus aureus*, *Candida albicans*) in PRP and platelet-poor plasma (PPP) was compared.
Main Results:
- Microbial colonies were detected at venipuncture sites in 60% of patients and in 67% of preparation facilities.
- FCM detected microbial contamination at concentrations of 10^2-10^3 CFU/mL in PRP, with limitations in detecting *C. albicans*.
- PCR showed high false-negative/positive rates in PRP samples, despite good sensitivity with pure cultures.
Conclusions:
- Venipuncture and PRP production processes pose risks for microbial contamination.
- Enhanced disinfection protocols and facility-specific measures are recommended to mitigate contamination.
- FCM is a promising tool for detecting viable bacteria in PRP, though further improvements in sensitivity are required. Clinicians must remain vigilant for potential infections.
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