ORIGINAL PAPER. Relative values of the interventions of diversion and improved donor‐arm disinfection to reduce the bacterial risk from blood transfusion

McDonald, Carl; Roy, Anjana; Mahajan, Priya; Smith, Richard; Charlett, André; Barbara, J. A. J.

doi:10.1111/j.0042-9007.2004.00404.x

Cited by 99 publications

(114 citation statements)

References 10 publications

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“…Since the risk of blood product contamination is associated with the presence of bacterial flora on donor arm which can contaminate the whole blood as soon as the blood collection is started, it is advisable to divert first few ml of blood into a separate pouch. McDonald et al [15] have reported that the effective donor arm disinfection in combination with diversion of initial volume of blood donation from the collection bag is the best approach to prevent blood bag contamination.…”

Section: Discussionmentioning

confidence: 99%

Impact of Donor Arm Cleaning with Different Aseptic Solutions for Prevention of Contamination in Blood Bags

Patel

Shukla

Gupte

2012

Indian J Hematol Blood Transfus

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Transfusion associated sepsis cases are encountered occasionally and bacterial transmission remains the major cause. The goal of our study was to compare the efficacy of disinfectants in phlebotomy site preparation. After selection of donor the antecubital fossa area of the arm was disinfected with different types of disinfectants namely sprit (70% isopropyl alcohol), povidone iodine (0.5% w/v available iodine in distilled water), savlon (1.5% v/v chlorhexidine gluconate solution and 3.0% cetrimide solution) and combination of sprit and povidone iodine. Swabs were collected from 20 donors using a sterile forceps, after cleaning with different antiseptic solutions. Swab was streaked on blood agar plate aseptically and the plate was incubated at 37°C for 24 h. Colonies were counted and a single colony was recultured by growing on nutrient and Mac-Conkey agar. The biochemical characteristics were determined by performing Gram staining, Motility, Catalase and Oxidase tests. The mean values of colonies were significantly higher with savlon compared to other three solutions. The difference was statistically significant by ''t'' test (t values 1.7-3.0; P \ 0.05). Staphylococcus epidermidis, Staphylococcus sp., Streptococcus sp., Micrococcus sp., Bacillus megaterium and Bacillus cereus were the organisms identified. After completion of bleeding, samples from the bag were aseptically inoculated in aerobic and anaerobic culture bottles to be tested on BacT/Alert system. The bag containing donor's blood did not show any contamination when three cleanings were carried out using sprit, povidone iodine and spirit respectively.

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Section: Discussionmentioning

confidence: 99%

Impact of Donor Arm Cleaning with Different Aseptic Solutions for Prevention of Contamination in Blood Bags

Patel

Shukla

Gupte

2012

Indian J Hematol Blood Transfus

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“…Special collection bags were manufactured for a study to determine the effectiveness of diversion [15]. These bags consisted of two sampling pouches attached to the standard collection bag configuration.…”

Section: Schlüsselwörtermentioning

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 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].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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ORIGINAL PAPER. Relative values of the interventions of diversion and improved donor‐arm disinfection to reduce the bacterial risk from blood transfusion

Abstract: The study validates diversion and an improved donor-arm disinfection procedure. In combination, these two interventions produced a substantial reduction in contamination. These procedures are to be introduced by the English National Blood Service to enhance the safety of the blood supply.

Cited by 99 publications

References 10 publications

Impact of Donor Arm Cleaning with Different Aseptic Solutions for Prevention of Contamination in Blood Bags

Impact of Donor Arm Cleaning with Different Aseptic Solutions for Prevention of Contamination in Blood Bags

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

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

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