Evaluation of the BacT/Alert automated blood culture system for detecting bacteria and measuring their growth kinetics in leucodepleted and non‐leucodepleted platelet concentrates

McDonald, Carl; Roy, Anjana; Lowe, Peter; Robbins, S.; Hartley, Stephen W.; Barbara, J. A. J.

doi:10.1046/j.0042-9007.2001.00104.x

Cited by 54 publications

(65 citation statements)

References 15 publications

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“…20 In both, PLT components quarantined at collection (Day 0) were sampled on Day 1 with test results read 18 to 24 hours later. Negatively screened components were available from end of Day 2 up to 7 days postcollection.…”

Section: Bacterial Screeningmentioning

confidence: 99%

A randomized noninferiority crossover trial of corrected count increments and bleeding in thrombocytopenic hematology patients receiving 2‐ to 5‐ versus 6‐ or 7‐day–stored platelets

MacLennan¹,

Harding

Llewelyn

et al. 2015

Transfusion

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BACKGROUND: Bacterial screening offers the possibility of extending platelet (PLT) storage to Day 7. We conducted a noninferiority, crossover trial comparing PLTs stored for 6 or 7 days versus 2 to 5 days. STUDY DESIGN AND METHODS: Stable hematology patients were allocated to receive blocks of 2-to 5-and 6-or 7-day PLTs in random order. The primary outcome was the proportion of successful transfusions during the first block, defined as a corrected count increment (CCI) of more than 4.5 at 8 to 24 hours posttransfusion. RESULTS: Of 122 patients with an evaluable first block, 87 (71%) and 84 (69%) had successful transfusions after 2-to 5-and 6-or 7-day PLTs of mean (SD) ages of 3.8 (1.0) and 6.4 (0.5) days, respectively. Six-or 7-day PLTs were declared noninferior to 2-to 5-day PLTs since the upper confidence interval (CI) limit was less than the predefined noninferiority margin of 10% (95% CI, 214.0% to 9.1%; p 5 0.766). Logistic regression analysis gave an adjusted odds ratio of 0.86 (95% CI, 0.47-1.58; p 5 0.625). Mean (SD) 8-to 24-hour CCIs were 9.4 (7.9) and 7.7 (7.1) after transfusion with 2-to 5-or 6-or 7-day PLTs (95% CI, 23.31 to 0.03; p 5 0.054). The proportions of days with bleeding scores of WHO Grade 2 or higher were 13% (38/297 days) and 11% (32/296 days; 95% CI, 23.2 to 7.2; p 5 0.454). Median interval to next PLT transfusion (2 days) was unaffected (95% CI, 210.5 to 5.4; p 5 0.531). CONCLUSION: In hematology patients, there was no evidence that 6-or 7-day PLTs were inferior to 2-to 5-day PLTs, as measured by proportion of patients with successful transfusions, bleeding events, or interval to next transfusion.

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Section: Bacterial Screeningmentioning

confidence: 99%

A randomized noninferiority crossover trial of corrected count increments and bleeding in thrombocytopenic hematology patients receiving 2‐ to 5‐ versus 6‐ or 7‐day–stored platelets

MacLennan¹,

Harding

Llewelyn

et al. 2015

Transfusion

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“…A National Health Service Blood and Transplant (NHSBT) retrospective monitoring study was established in 1995 to determine the bacterial contamination rate in blood components using an automated microbial detection system [10,11]. The study was also used to determine the effectiveness of any interventions implemented to reduce bacterial contamination.…”

Section: Introductionmentioning

confidence: 99%

Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service

McDonald

2011

Transfus Med Hemother

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Background: Bacterial contamination remains a significant problem in transfusion medicine. A National Health Service Blood and Transplant (NHSBT) study and surveillance data indicated skin commensals derived from the skin of the donor are the major contaminants of blood components. NHSBT therefore explored two interventions: improved donor arm disinfection and diversion. Methods: Improved donor arm disinfection: Commercial and in-house methods of disinfection were evaluated. Swabs at the venepuncture site were taken before and after disinfection and the reduction in bioburden determined. Diversion: Special collection bags were manufactured to allow the initial volume of blood to flow into a pouch, representing the diversion pouch and then the next flow of blood into another pouch representing the collection bag. Pouches were screened for the presence of bacteria. The reduction in bacterial contamination was then determined. Results: A two-step commercial procedure (Donor Prep Kit; DPK) consisting of 70% isopropyl alcohol followed by tincture of iodine was shown to be a best practice procedure (2-min procedure). A 99.79% reduction was obtained, and this method was 10 times more effective than current practice at that time. The DPK was shown in a field trial to increase donor waiting time. A second study was initiated to find a more rapid procedure. ChloraPrep®, consisting of 2% chlorhexidine gluconate and 70% isopropyl alcohol, was shown to have equivalent disinfection efficiency as the DPK, but only took 1 min to perform. In 2006, ChloraPrep was introduced as the national method of donor arm disinfection. Diversion was shown to give a 47% reduction in contamination and was introduced nationally in 2002. Conclusion: Improved donor arm disinfection and diversion are effective, low-cost interventions, but do not eliminate all bacterial transmissions. In 2011, bacterial screening of platelet components was introduced by NHSBT to further increase the safety of the blood supply.

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“…These include visual inspection [20,21], endotoxin assays [22], direct staining [23], ribosomal assays [24][25][26][27] and direct culture (manual or automated) [28][29][30][31]. As a general rule, the more rapid a bacterial detection assay, the lower its sensitivity.…”

Section: Pretransfusion Detection Of Bacteriamentioning

confidence: 99%

“…With the use of automated blood culture techniques, positive results are usually obtained within 24 h of inoculation for most bacterial species [28,[30][31][32]. However, it lacks a consensus on the timing and duration of culture, but it is getting more commonly used in many countries [33][34][35][36].…”

Section: Pretransfusion Detection Of Bacteriamentioning

confidence: 99%

Bacterial contamination of blood products

Lee¹

2011

ISBT Science Series

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Evaluation of the BacT/Alert automated blood culture system for detecting bacteria and measuring their growth kinetics in leucodepleted and non‐leucodepleted platelet concentrates

Cited by 54 publications

References 15 publications

A randomized noninferiority crossover trial of corrected count increments and bleeding in thrombocytopenic hematology patients receiving 2‐ to 5‐ versus 6‐ or 7‐day–stored platelets

A randomized noninferiority crossover trial of corrected count increments and bleeding in thrombocytopenic hematology patients receiving 2‐ to 5‐ versus 6‐ or 7‐day–stored platelets

Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service

Bacterial contamination of blood products

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