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Published on: August 24, 2015
Detecting bacterial contamination in platelet products
Elizabeth L Palavecino1, Roslyn A Yomtovian, Michael R Jacobs
1Department of Pathology, Wake Forest University Medical School, Winston-Salem, North Carolina, USA.
Abstract:
Bacterial contamination of platelets is an important cause of transfusion-associated morbidity and mortality. It is currently the most frequent infectious complication of transfusion therapy, with between 1 in 1,000 and 1 in 3,000 platelet units being bacterially contaminated at time of transfusion. Several factors have contributed to the persistence of this problem including lack of sensitive detection methods, lack of recognition of the frequency of the problem, inadequate recognition of septic reactions by clinicians treating patients receiving platelet transfusions, differences in transfusion reactions between bacterial species and bacterial inocula transfused, and differing methodologies and time of testing for detection of bacteria in platelet units. There are also important correlations between the receipt of bacterially contaminated platelet units and the development of transfusion reactions and bacteremia. In the last few years the recognition of the importance of platelet bacterial contamination prompted the College of American Pathologists (CAP) and the American Association of Blood Banks (AABB) to set new standards requiring the screening of platelets for bacterial contamination. In the wake of these standards, an increasing number of approaches have been and are being developed to deal with this problem. The clinical sensitivity, specificity and predictive value of these detection methods vary considerably and need to be defined for routine laboratory practice. In this review, we focus on the practical aspects and feasibility of implementing FDA-cleared detection methods for identifying bacterially contaminated platelet units. We also present details of a number of methods under development for at-issue use.
Insights
Bacterial contamination in platelet units is a frequent issue, causing transfusion-associated illness and death. New screening methods are being developed and evaluated to improve detection and patient safety.
Area of Science:
- Transfusion Medicine
- Microbiology
- Clinical Pathology
Background:
- Bacterial contamination of platelets is a significant cause of transfusion-associated morbidity and mortality.
- It is the most common infectious complication of transfusion therapy, affecting 1 in 1,000 to 3,000 units.
- Factors contributing to this problem include detection method limitations and underrecognition of septic reactions.
Purpose of the Study:
- To review the practical aspects and feasibility of implementing FDA-cleared methods for detecting bacterial contamination in platelet units.
- To discuss methods under development for real-time use in blood banks.
- To highlight the need for defining the clinical sensitivity, specificity, and predictive value of these detection methods.
Main Methods:
- Review of existing literature on bacterial contamination in platelet units.
- Evaluation of FDA-cleared detection methods for practical implementation.
- Discussion of emerging technologies for at-issue bacterial detection.
Main Results:
- New standards from CAP and AABB mandate screening of platelets for bacterial contamination.
- Various detection methods are being developed, but their clinical performance varies.
- The sensitivity, specificity, and predictive value of these methods require further definition for routine use.
Conclusions:
- Bacterial contamination of platelets remains a critical safety concern in transfusion medicine.
- Implementing effective screening strategies is essential to mitigate transfusion-associated risks.
- Ongoing development and validation of sensitive detection methods are crucial for improving blood product safety.
