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Published on: August 24, 2015
Blood surveillance and detection on platelet bacterial contamination associated with septic events
1Department of Pathology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Abstract:
The objective of this study was to evaluate the risk of transfusion-associated septic events in Taiwan. In Taiwan, most blood components are provided from blood centres; so platelet (PLT) bacterial contaminations are rarely reported. The study's aim is to investigate the prevalence of PLT bacterial contamination in Kaoshiung Armed Forces General Hospital by using BacT/ALERT system for routine screening. A total of 82 apheresis and 2256 whole blood-derived PLT units were tested. A measured quantity of 1 mL aliquots were taken as samplings from all blood bag tubing of PLT units, and then further incubated in a bacterial detection system (BacT/ALERT). The subcultures of true-positive bottles underwent bacterial identification by using Vitek system, microscopic observation and culture-based methods. Eight units (0.34%, 8 of 2338) were found to have bacterial contamination. The true-positive rate of the whole blood-derived and apheresis PLTs was 0.31% (7 of 2256) and 1.22% (1 of 82), respectively. Six microorganisms were identified with the most dominate being Staphylococcus epidermidis. One case of transfusion-associated sepsis was confirmed; in addition, the holding period of PLTs (F = 4.522, P = 0.034) and positive detection of PLT bacterial contamination (F = 46.605,P < 0.001) were associated with post-transfusion sepsis. Thus, in this study, although the transfusion-associated septic event was rarely found and PLT units were provided from blood centres, bacterial screening was necessary to safely quarantine the transfusion. The holding period of PLT units should be no more than 4 days in order to avoid possible bacterial contamination.
Insights
Bacterial contamination in platelet (PLT) transfusions is rare but serious. Routine screening and limiting PLT holding time to four days are crucial for preventing transfusion-associated sepsis.
Area of Science:
- Transfusion Medicine
- Microbiology
- Infectious Disease
Background:
- Transfusion-associated septic events pose a risk, although platelet (PLT) contamination is infrequently reported in Taiwan due to centralized blood component provision.
- Investigating the prevalence of bacterial contamination in PLTs is essential for patient safety.
Purpose of the Study:
- To evaluate the risk of transfusion-associated septic events in Taiwan.
- To determine the prevalence of bacterial contamination in platelet units at Kaohsiung Armed Forces General Hospital using routine screening.
Main Methods:
- Screening of 82 apheresis and 2256 whole blood-derived platelet units using the BacT/ALERT bacterial detection system.
- Identification of contaminating microorganisms through Vitek system, microscopy, and culture-based methods.
Main Results:
- Eight units (0.34%) showed bacterial contamination, with rates of 0.31% for whole blood-derived and 1.22% for apheresis PLTs.
- Staphylococcus epidermidis was the most common contaminant. Positive contamination and longer PLT holding periods were associated with post-transfusion sepsis.
Conclusions:
- Despite low reported rates, bacterial screening of platelets is necessary to prevent transfusion-associated sepsis.
- Limiting the holding period for platelet units to a maximum of four days is recommended to minimize contamination risk.
