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Bacterial screening of platelet components: Experience at a hospital-based blood bank
Arwa Z Al-Riyami1,2, Y Al-Ruzeiqi3, I Al-Omairi1
1Department of Hematology, Sultan Qaboos University Hospital, University Medical City, Muscat, Oman.
Background And Objectives:
Bacterial contamination of platelets stored at room temperature poses the highest risk of infection and fatality. Our hospital-based blood bank performs bacterial culture using the Bactec™ FX system for all whole blood-derived and apheresis units. Approximately 1 mL is collected from each of three to four buffy coat whole blood-derived platelet concentrates (PCs). The pooled sample is then inoculated into a single aerobic paediatric culture bottle. For apheresis units, 3 mL is inoculated per unit. Inoculation is performed at least 12 h after donation or 16-24 h after processing, when feasible. This study aims to determine the prevalence of culture-positive PCs.
Materials And Methods:
A retrospective review of the blood bank's records from April 2021 to August 2023 was carried out. The number of positive platelet cultures, identified organisms and their clinical significance were analysed. Clinical records were reviewed for any reported transfusion reactions.
Results:
A total of 5009 PCs were cultured. The rate of initial positive Bactec™ FX system results of pooled samples was 1.7%, corresponding to 85 PCs. Staphylococcus species accounted for 48% of the identified organisms. Upon repeat testing from individual PCs, five units (1:1000 units) were confirmed to be positive: four with Micrococcus luteus and one with Gram-positive bacilli. No clinical sequelae were reported in the recipients.
Conclusion:
This study demonstrates a low platelet culture positivity rate, with the most common contaminant being Staphylococcus species. Further studies are required to evaluate the feasibility of a large-volume delayed-sampling testing protocol in our setting.
Insights
Bacterial contamination in platelets is a serious risk. This study found a low rate of positive platelet cultures (0.1%) using the Bactec™ FX system, with Staphylococcus species being the most common contaminant.
Area of Science:
- Transfusion Medicine
- Microbiology
- Infectious Disease
Background:
- Platelets stored at room temperature carry a high risk of bacterial contamination, leading to severe infections and fatalities.
- Hospital blood banks routinely screen platelet concentrates (PCs) for bacterial contamination to ensure transfusion safety.
Purpose of the Study:
- To determine the prevalence of culture-positive platelet concentrates (PCs) in a hospital-based blood bank.
- To identify the types of microorganisms contaminating PCs and assess their clinical significance.
Main Methods:
- A retrospective review of bacterial culture records for 5009 platelet units from April 2021 to August 2023.
- Utilized the Bactec™ FX system for bacterial culture of pooled samples from whole blood-derived and apheresis platelet units.
- Analyzed positive culture results, identified organisms, and reviewed clinical records for transfusion reactions.
Main Results:
- An initial positive culture rate of 1.7% (85 out of 5009 PCs) was observed.
- Staphylococcus species were the most frequently identified organisms (48%).
- Confirmatory testing revealed a final positivity rate of 0.1% (5 out of 5009 PCs), with Micrococcus luteus and Gram-positive bacilli identified; no clinical sequelae were reported.
Conclusions:
- The study indicates a low rate of bacterial contamination in platelet concentrates when using the Bactec™ FX system.
- Staphylococcus species are the predominant contaminants found in platelet cultures.
- Further research is needed to assess the viability of large-volume, delayed-sampling testing protocols for platelet safety.
