Contamination of platelet concentrates with Staphylococcus aureus induces significant modulations in platelet functionality

Background and Objectives Platelet concentrates (PCs) contaminated with Staphylococcus aureus can escape detection during PC screening, causing septic transfusion reactions. This study aimed to determine the impact of S. aureus contamination on platelet metabolism and functionality during PC storage. Materials and Methods Targeted metabolomics (N = 3) was performed on non‐spiked PCs and PCs inoculated with 10–20 colony‐forming units (CFU)/bag of S. aureus. Metabolites were quantified at 0, 48 and 144 h using high‐performance mass spectrometry (MS). Additionally, PCs spiked with approximately 20 CFU/bag of S. aureus were sampled every 24 h for up to 144 h to evaluate platelet functionality using flow cytometry (N = 2). Results Eight metabolites had significantly different levels in spiked PCs (log2 fold‐change ≤ or ≥±1) versus non‐spiked units at 48 and 144 h. Xanthine, uridine, serine, glutamine and threonine were increased, whereas orotic acid, dihydroorotic acid and aspartic acid were decreased. Flow cytometry showed a significant decrease in expression of GPIIb while P‐selectin expression was significantly increased in spiked PCs after 72 h of storage when S. aureus concentration was ≥10E+08 CFU/ml. Additionally, phosphatidylserine exposure was significantly increased after 48 h of PC storage, when S. aureus had reached a concentration of 2E+06. Conclusion Contamination with S. aureus exacerbates platelet storage lesions in contaminated PCs but only when the bacterium has reached clinically significant levels.