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Updated: Jul 8, 2025
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
The operational and financial impact of adding anaerobic screening of platelets
Jorge Rios1, Jonathan Webb2, Beth Dy2
1American Red Cross Biomedical, Dedham, Massachusetts, USA.
Background And Objectives:
We evaluated the operational and safety impact of implementing anaerobic culture screening of apheresis and pooled platelets at the American Red Cross on the already established use of the aerobic culture screening of each donation performed no sooner than 24 h following collection.
Materials And Methods:
Platelets were screened for bacterial contamination with the BACT/ALERT 3D® (bioMérieux, Durham, NC) microbial detection testing system. The addition of anaerobic culture to the already existing aerobic culture resulted in sampling an additional 8-10 mL from each donation.
Results:
Implementation of anaerobic testing resulted in an approximate 3.5-fold increased rate of False Positive BACT/ALERT alarms. There was a modest increase in the rate of True Positive alarms of 1.4-fold with increased detection of Klebsiella and Propionibacterium species, including Cutibacterium acnes. In addition, there was an approximate 3.5-fold increase rate of False Positives and a 13.5-fold increase rate of Indeterminates, the majority (~57%) were due to Cutibacterium acnes. The combined costs and lost revenue associated with adding anaerobic screening increased by ~$1,000,000/year due to testing cost and product discards.
Conclusion:
The addition of anaerobic culture to aerobic culture to the original donation (without the introduction of sampling delay) resulted in a significant increase in the rate of alerts. The 40% increased rate of True Positive alarms may have modestly improved platelet safety. However, there was a disproportionate increase in the rate of False Positive and Indeterminate bacterial culture alarms, which added substantial cost and overall loss of platelet products.
Insights
Adding anaerobic screening to platelet cultures increased false alarms and costs significantly, with only a modest improvement in true positive detection for bacterial contamination.
Area of Science:
- Transfusion Medicine
- Microbiology
- Public Health
Background:
- Established aerobic culture screening for bacterial contamination in blood donations.
- Evaluated the impact of adding anaerobic culture screening to apheresis and pooled platelets.
Purpose of the Study:
- To assess the operational and safety impact of implementing anaerobic culture screening for platelet products.
- To analyze the changes in bacterial detection rates, false positives, and indeterminate results.
Main Methods:
- Utilized the BACT/ALERT 3D® microbial detection system for both aerobic and anaerobic cultures.
- Collected additional 8-10 mL samples for anaerobic culture from each donation.
Main Results:
- Observed a 3.5-fold increase in false positive alarms and a 13.5-fold increase in indeterminate results, largely due to Cutibacterium acnes.
- A 1.4-fold increase in true positive alarms detected Klebsiella and Propionibacterium species.
- Estimated an annual increase of ~$1,000,000 in costs and lost revenue due to testing and product discards.
Conclusions:
- The addition of anaerobic culture significantly increased alert rates, including false positives and indeterminates.
- While true positive detection saw a modest increase, the rise in false alarms and indeterminates led to substantial costs and product loss.
- The operational and financial impact of adding anaerobic screening outweighed the marginal safety benefits.
