Effects of skin disinfection method, deviation bag, and bacterial screening on clinical safety of platelet transfusions in the Netherlands

Abstract

The use of the diversion bag and, to a lesser extent, the use of double swabs with 70 percent isopropyl alcohol, led to a reduction of contamination. As expected, predominant contamination with resident skin bacteria was reduced. The combination of diversion bag and new disinfection led to a frequency of initial positive results for pooled five-donor PCs, which is similar to that of single-donor apheresis PCs. Furthermore, the bacterial detection system and associated product recall procedures have been shown to be effective in preventing transfusion of contaminated PCs and/or related red cells, especially for rapidly growing bacteria.

Screening of platelet concentrates for bacterial contamination: spectrum of bacteria detected, proportionof transfused units, and clinical follow-up

“…The spectrum of detected microorganisms derives predominantly, as expected, from the transient and resident skin flora and shows the limits of skin disinfection [3]. The microbial spectrum is comparable to that of other studies which also performed aerobic and anaerobic cultures [3,4,7].…”

“…The microbial spectrum is comparable to that of other studies which also performed aerobic and anaerobic cultures [3,4,7]. The high proportion of PCs contaminated with Propionibacteria is striking, accounting for 54% of confirmed positive PCs and 46% of potentially positive PCs.…”

“…A series of studies reports on the screening results of PCs with automated culture systems [3,4,6,7,[14][15][16][17]. Comparability of the results is limited.…”

“…These include a specific donor history to identify asymptomatic bacteremia, appropriate skin disinfection procedures before venipuncture, initial aliquot diversion, and consistent implementation of the principles of good manufacturing practice with defined hygiene standards [2,3].…”

Novel Flow Cytometry–Based Screening for Bacterial Contamination of Donor Platelet Preparations Compared with Other Rapid Screening Methods

“…Screening of platelet preparations (PLTs) 2 for bacterial contamination by prospective culture testing has been implemented as part of the quality assurance program in several blood services. Despite screening of PLTs for bacterial contamination by culture, it has been demonstrated that there is still a substantial infection risk associated with transfusing PLTs, and septic complications have been observed in recipients, particularly with PLTs Ͼ4 days old (2)(3)(4)(5)(6)(7)(8)(9)(10). Early sampling strategies exhibit a high risk of sampling error, particularly when slow-growing bacteria are involved in the contamination.…”