Platelet concentrates safety: a focus on the challenging pathogen Staphylococcus aureus—a narrative review
Bibliographic record
Abstract
Background and Objective: Contamination of platelet concentrates (PCs) with Staphylococcus aureus (S. aureus) is a significant concern in transfusion medicine. This pathogen can escape detection during routine PC screening with culture methods and in rare occasions resist pathogen reduction treatment. The aim of this narrative review is to provide up-to-date information on the modulation of molecular mechanisms of S. aureus that impact the safety of PC transfusion patients. Methods: Retrospective and observational studies were searched in PubMed and Google Scholar from January 2014 to October 2024 with the terms: “platelet concentrates”, “bacterial contamination”, “Staphylococcus aureus”, “transcriptome analyses”, “virulence factors”, and “metabolic adaptation”. Furthermore, analysis of comparative transcriptome data of S. aureus grown in PCs vs. media was added to complement/support findings of the literature review. Key Content and Findings: The literature review and transcriptome data revealed interesting phenotypic and genotypic characteristics of S. aureus, including expression of virulence determinants and adoption of alternative metabolic pathways in the harsh PC storage niche, posing a threat for transfusion patients. Although PCs provide a unique and challenging environment for S. aureus with a combination of physiological stressors, host defenses, and limited nutrient availability, this bacterium has developed sophisticated strategies to interfere with platelet immunomodulatory factors, resist immune clearance, and adapt to difficult survival conditions. Transcriptome analysis showed that the PC storage environment triggers upregulation of S. aureus genes responsible for cell wall modification, capsule production, and biofilm formation, which protect the bacterium from platelet and plasma-derived antimicrobial peptides, and environmental stressors. Additionally, genes encoding for proteins involved in alternative metabolic pathways, like anaerobic fermentation and nutrient acquisition, are upregulated in PCs compared to media. Comparative RNA-seq analyses of S. aureus cultured in PCs vs. media indicate that this bacterium switches onto a quiescent state to survive challenging PC storage conditions by minimizing energy expenditure, altering metabolic pathways, and enhancing resistance to environmental stresses. Conclusions: S. aureus adaptation to the PC storage environment results in molecular modulation of key factors involved in persistence and pathogenicity, posing a challenge for detection and eradication in contaminated PC units, with a potential detrimental outcome for transfusion patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".