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Detecting bacteria in platelet concentrates by use of reagent strips
J B Werch1, Paulette Mhawech, C E Stager
1Department of Pathology, Baylor College of Medicine; and The University of Texas M. D. Anderson Cancer Center, Houston, USA. jwerch@bcm.tmc.edu
Background:
Iatrogenic infection of immunosuppressed or immunocompromised hosts secondary to receipt of blood components containing bacteria may result in serious adverse outcomes. Measurement of pH and glucose by use of inexpensive reagent strips has been proposed as a practical means of screening for bacteria in platelet concentrate (PC) units.
Study Design And Methods:
Glucose and pH were measured in 3093 PC units by use of reagent strips (Multistix, Bayer Corp.) to screen for bacterial content. Any PC classified by the reagent strip method as containing bacteria was subsequently cultured to confirm the presence and quantity of bacteria present.
Results:
Thirty of 3093 PC units were classified as containing bacteria by the reagent strip method. Two of the 30 PC units positive by the reagent strip method were also positive by standard bacterial culture technique. Bacillus cereus was isolated from both units.
Conclusion:
Screening PC units by the reagent strip method resulted in 9.7 units per 1000 being wasted, but prevented two patients from receiving a PC unit containing B. cereus.
Insights
Screening platelet concentrate (PC) units using reagent strips for pH and glucose can detect bacterial contamination. This method, while wasting some units, successfully prevented two patients from receiving potentially harmful Bacillus cereus-contaminated blood products.
Area of Science:
- Transfusion Medicine
- Microbiology
- Clinical Pathology
Background:
- Bacterial contamination of platelet concentrates (PCs) poses a significant risk to immunocompromised patients.
- Screening PCs for bacteria is crucial to prevent serious adverse events.
- Reagent strips measuring pH and glucose offer a potentially practical screening method.
Purpose of the Study:
- To evaluate the efficacy of reagent strips for screening bacterial contamination in platelet concentrate units.
- To assess the practicality and impact of reagent strip screening on PC wastage and patient safety.
Main Methods:
- A total of 3093 PC units were screened using reagent strips to measure pH and glucose.
- Units flagged by the reagent strip method were subsequently cultured to confirm bacterial presence and quantify.
- Standard bacterial culture techniques were used as a confirmatory test.
Main Results:
- The reagent strip method identified 30 out of 3093 PC units as potentially contaminated.
- Bacterial culture confirmed contamination in two of these 30 units.
- Bacillus cereus was the identified contaminant in both positive cases.
Conclusions:
- Reagent strip screening for bacterial contamination in PCs resulted in a wastage rate of 9.7 units per 1000.
- Despite wastage, the method successfully prevented two patients from receiving PCs contaminated with Bacillus cereus.
- This screening approach offers a balance between resource utilization and patient safety in transfusion medicine.
