Table 2.
Level of recommendation and corresponding diagnostic test for the main microorganisms responsible for transfusion-transmissible infections (TTI) advised by US, European and Italian guidelines (GLs)
| Aetiological agent (disease) | US GLs, 2005 8 | Test advised | US GLs, 2016 9 * | Test advised | European GLs 10 | Test advised | Italian GLs, 2008 11 | Test advised | Italian GLs, 2016 12 | Test advised |
|---|---|---|---|---|---|---|---|---|---|---|
| FeLV | R | Rapid antigen ELISA | R | Rapid antigen test (M) FeLV provirus PCR (O) |
R | FeLV provirus PCR | R | Rapid antigen test | R | Rapid antigen test |
| FIV | R | Antibody ELISA | R | Rapid antibody test (M) | R | Rapid antibody test | R | Rapid test | R | Rapid test |
| Mycoplasma haemofelis, Mycoplasma haemominutum, Mycoplasma turicensis (haemoplasmosis) | R (M turicensis is not considered) |
Microscopy, PCR | R (M haemominutum and M turicensis are considered optional because they are not a primary pathogen) |
PCR (M for M haemofelis; O for M haemominutum and M turicensis) |
R | Blood PCR | R (M haemominutum and M turicensis are not considered) |
Microscopy | R (M haemominutum and M turicensis are not considered) |
Microscopy, IFAT, PCR |
| Coronavirus (FIP) | N | – | N | N | N | FCoV antibody negative preferred | FCoV antibody negative | – | NC † | – |
| Bartonella henselae (bartonellosis) | R/C | IFAT, PCR, culture | R | Serology (O) PCR (M) culture (O) |
R | IFAT and/or blood PCR | NC | – | NC | – |
| Bartonella species | R/C | IFAT, PCR, culture | C | PCR (O) | R | IFAT and/or blood PCR | NC | – | NC | – |
| Ehrlichia species (ehrlichiosis) | C | PCR | C | PCR (O) | C | Blood PCR | NC | – | NC | – |
| Anaplasma phagocytophilum (anaplasmosis) | C | IFAT, PCR | C | Serology (O) PCR (M) |
C | IFAT and blood PCR | NC | – | NC | – |
| Anaplasma platys (anaplasmosis) | C | IFAT, PCR | C | PCR (O) | C | IFAT and blood PCR | NC | – | NC | – |
| Neorickettsia ristici (neorickettsiosis) | C | – | C | PCR (O) | NC | – | NC | – | NC | – |
|
Rickettsia species (rickettsiosis) |
NC | – | N | – | N | – | NC | – | NC | – |
| Toxoplasma gondii (toxoplasmosis) | N | – | N | – | N | – | NC † | – | NC † | – |
| Cytauxzoon felis (cytauxzoonosis) | C ‡ | Microscopy § | C | PCR (O) | C | Blood PCR | NC | – | NC | – |
| Babesia species (babesiosis) | NC | – | NC | – | C | Blood PCR | NC | – | NC | – |
| Leishmania infantum (leishmaniosis) | NC | – | NC | – | C | Blood PCR | NC | – | NC | – |
Latest version of US GLs 9 classified recommendations for optimal standards and minimal standards for each microorganism. Tests considered only in optimal standards are labelled ‘O’, whereas tests considered only in minimal standards are labelled ‘M’. The optimal standard minimises the risk of TTI using the best diagnostic tests currently available for TTI, whereas the minimal standard considers limits of cost and time or difficulties in finding laboratories performing specific tests. To permit the comparison among GLs in this table, microorganisms that must be investigated both in the optimal and the minimal standards are considered R (recommended), whereas those that must be investigated only in the optimal standard are considered C (conditional)
A temporary exclusion from donation is provided
Based on the epidemiological situation. The US GLs advise a geographical and breed restriction 9
PCR protocols were not available at the time of the publication of the GLs
FeLV = feline leukaemia virus; FIV = feline immunodeficiency virus; IFAT = immunofluorescent antibody test; FIP = feline infectious peritonitis; N = not recommended; FCoV = feline coronavirus; NC = not considered