The Best Proposal of Treponema Pallidum Detection for Blood Services

Abstract

Objective To explore the optimal scheme of treponema pallidum (TP) detection in blood services,to reduce the TP infection caused by blood transfusion.Methods From January 2012 to December 2013,a total of 50 000 blood donors in Dongying Central Blood Station were included in this study.Two kinds of TP-enzyme-linked immunosorbent assay (ELISA) kit from different manufacturers and toluidine red unheated serum test (TRUST) kit were used to detect these donors'TP,respectively.The donors whose TP-ELISA detection results were negative,but TRUST detection results were positive,were required to be retested TP by twice ELISA test and once TRUST test,3 months after blood donation.Blood samples were confirmed as serology positive by twice ELISA detection positive or both ELISA and TRUST detection positive.In the period 2011 to 2013,the donors who donated blood more than three times,and were eliminated because of TP positive,were followed-up investigation at least 3 months.These donors were investigated whether to participate in blood donation after dirty sex.Results In 50 000 blood donors,a total of 171 cases were TP positive,including 163 cases of TP-ELISA positive,167 cases of TRUST positive,and 159 cases were both positive.In TP positive results,8 cases were negative of TP-ELISA test results,but positive of TRUST test results,accounting for 4.6％ (8/171).4 cases were TRUST negative,but TP-ELISA positive,accounting for 2.3％ (4/171).There was statistical difference in TP detection results between TP-ELISA and TRUST test (x2=134.42,P＜0.05).Only 2 cases were both TP-ELISA and TRUST positive in 8 donors who were TRUST positive.The difference of serology results was statistically significant between initial inspection and re-inspection (x2 =5.25,P＜0.05).In the follow-up of 11 cases of blood donors,five cases admitted they had unclean sexual history before the blood donation,accounting for 45.5％ (5/11).Conclusions The best scheme of TP detection should be once TP-ELISA detection and once TP nonspecific antibody detection.Twice TP-ELISA detection is questionable in most blood stations (blood center) currently.Fixed blood donors who were TP serological positive after blood donation should be tracked. Key words: Blood services; Treponema pallidum screening; Proposal