Bacterial contamination of blood components is the major infectious risk in transfusion medicine. Since platelets should be stored at room temperature that makes them an excellent growth medium for bacteria; it is mentioned as a major problem in transfusion medicine. Transfusion risk of a bacterial contaminated platelet concentrate is higher than viral pathogen such as HIV, HBV, HCV and HTLV. The objective of this study was to evaluation of the sensitivity and specificity of use of glucose and pH for bacterial screening of platelet concentrates compared to the Bact/Alert. 1332 platelet concentrates were screened by the Bact/Alert system for aerobic and anaerobic bacterial contamination. Bacterial contamination was also evaluated by using urine reagent strips (Multistix10 SG Bayer) and culture methods. Moreover PH screening with a pH meter (Metrohm 744 Swiss) and glucose was also used for detection of bacterial contamination. The rate of bacterial contamination detected by the Bact/Alert system in platelet concentrates was 25 in 1332 (1.9 %). It contained 15 (1.1 %) for aerobic bacteria and 10 (.8 %) for anaerobic bacteria. 226 of 1332 were considered as containing bacteria by using urine reagent strips. Six of the 226 units were also positive by the Bact/Alert system. Three of those units were culture positive for aerobic bacteria and three for anaerobic. The result of platelet concentrates that underwent pH screening by use of pH meter and a pH portion of urine reagent strips was the same. The sensitivity and specificity of considering glucose alone for detection of bacterial contamination were 12 and 98 % respectively. For pH alone, these were 24 and 83 %. For glucose and/or pH, these were 24 and 83 %; and for combination of glucose and pH, these were 12 and 98 %. Our results showed use of glucose/pH strips would improve the safety of blood products and should be encouraged.
Background & Objective:
Bacterial, contamination of blood components are a significant risk for transfusion reactions. Inherently, platelet concentrates (PCs) are vulnerable to bacterial contamination, due to the storage condition of processed PCs at room temperature, which provide very suitable conditions for the proliferation of microorganisms.
The current study aimed at investigating the transfusion associated septic reaction rate in patients with hemato-oncological diseases in Imam Khomeini Hospital, Tehran, Iran, and identifying the contaminating bacteria.
Methods:
A total of 3056 adult patients of the Cancer Center of Imam Khomeini Hospital in Tehran transfused with PCs were studied based on the clinical symptoms of septic transfusion reaction from June 1, 2010 to May 31, 2011. Patient presented with the criteria of reaction and the residual components were evaluated for bacterial contamination by Bac T/Alert system.
Results:
Patients with leukemia or lymphoma transfused with random-donor PCs were evaluated the signs and symptoms of transfusion reaction occurred only in 12 (%0.4) cases. Automated cultivation found 3 positive blood cultures. Among these a male recipient was categorized as possible septic transfusion reaction and
Citrobacterfreundii
was isolated from blood sample.
Conclusion:
Appropriate clinical utilization of PCs transfusion, and ongoing vigilance to recognize, investigate, promptly treat, and report all suspicious transfusion reactions are necessary to manage the transfusion complication including transfusion-transmitted infections (TTI).
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