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Published on: August 24, 2015
Detection of bacterial contamination of platelet components: six years' experience with the BacT/ALERT system
Lars Munksgaard1, Lene Albjerg, Søren T Lillevang
1County of Funen Transfusion Service, Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.
Background:
Hemovigilance has shown that bacteria cause more fatalities than other infections together. Surveillance for detection of bacteria in platelets (PLTs) was initiated. Concomitantly, the storage period for PLTs was extended from 5 to 7 days to reduce cost.
Study Design And Methods:
Analysis was performed of all cases of a positive signal in a screening procedure for contaminated PLTs taking into account results of confirmative cultures and results of culture from blood components including bacteria strains. Records were assessed from patients transfused with blood components issued before the screening culture became positive.
Results:
Samples were collected from 22,057 PLT units. An initial reaction was seen in 84 (0.38%). Growth was confirmed in 70 of these. Of the associated PLT units, 26 had been issued or outdated at the time when the culture was found to be reactive, in 27 bacteria were found, and in 17 cultures were negative. The bacteria found were mainly from normal skin flora. Sixty-six patients received 75 blood components issued before the screening system alarmed. None of these patients had a transfusion reaction reported. The outdating fell to less than 5 percent.
Conclusion:
A screening system for detection of bacterial contamination was implemented without increase in cost owing to extension of storage time to 7 days. Transfusion of several contaminated blood components was prevented.
Insights
Implementing bacterial screening for platelet (PLT) units, alongside extended storage, effectively prevented contaminated transfusions without increasing costs. This crucial hemovigilance measure enhances patient safety by detecting bacterial infections.
Area of Science:
- Transfusion Medicine
- Microbiology
- Public Health
Background:
- Bacterial infections are a leading cause of transfusion-related fatalities.
- Platelet (PLT) storage was extended to 7 days to reduce costs.
- A screening system for bacterial contamination in PLTs was initiated.
Purpose of the Study:
- To evaluate the effectiveness of a bacterial screening system for platelet units.
- To assess the impact of extended PLT storage on cost and safety.
- To determine the rate and types of bacterial contamination in PLTs.
Main Methods:
- Analysis of positive screening signals in 22,057 PLT units.
- Confirmation of bacterial growth through cultures.
- Review of patient records for transfusions predating positive screening results.
Main Results:
- A 0.38% initial reaction rate in PLT screening, with confirmed bacterial growth in 70 units.
- Predominant bacteria identified were from normal skin flora.
- No reported transfusion reactions in 66 patients who received components issued before screening alerts; outdating reduced to <5%.
Conclusions:
- The bacterial screening system for PLTs was successfully implemented.
- Extended PLT storage to 7 days allowed cost reduction without compromising safety.
- The screening system prevented the transfusion of contaminated blood components.
