[Detection of bacterial contamination in platelet concentrates: perspectives]

Bacterial contamination of blood components represents today the highest infectious risk of blood transfusion, the risk is particularly high when it affects platelet concentrates. In France the prevention methods developed over the past six years (donor selection, phlebotomy site preparation, first 30 ml diversion, systematic leuko-reduction...) aimed at limiting the introduction of bacteria in blood and bacterial proliferation. Several methods have been tested for the detection of bacterial contamination in platelet concentrates but none have been generalised. Difficulties were met, due to the necessity of 1) detecting only the platelet concentrates presenting a real infectious risk, when the presence of bacteria is observed in 2.2% (2-4%) of donated blood and 2) guaranteeing the availability of platelet concentrates. New methods have been developed which seem able to bring responses to these difficulties. Several processes are being (or will be) assessed, including automated blood culture, bacterial genomic detection with or without amplification, flow cytometric methods. In parallel, an indirect method able to detect the presence of bacteria, based on oxygen consumption, will also be evaluated. One (or several) of these processes should allow, in the short-term, to detect platelet concentrates presenting an infectious risk. In the future, the interest of bio-chips for bacterial detection in biological fluids must be investigated.