Effects of skin disinfection method, deviation bag, and bacterial screening on clinical safety of platelet transfusions in the Netherlands
Authors:
- 26 January 2006
- journal article
- Published by Wiley in Transfusion
- Vol. 46 (3) , 476-485
Abstract
BACKGROUND: Bacterial contamination of blood products is a great hazard for development of fatal transfusion reactions. Bacterial screening of platelet concentrates (PC) by aerobic and anaerobic culturing (BacT/ALERT, bioMérieux) was introduced in the Netherlands in October 2001.STUDY DESIGN AND METHODS: In November 2002, a nationwide, uniform skin cleansing method was introduced with a double‐swab disinfection with 70 percent isopropyl alcohol. One location routinely used an integrated diversion bag to collect the first 20 to 30 mL.RESULTS: Over the calendar years 2002 and 2003, in total 113,093 PCs derived from pooled buffy coats were screened. After introduction of the new disinfection method, 0.85 percent were initially positive. This was a small reduction compared to the previous disinfection methods under which 0.95 percent were initially positive. The location with use of the diversion bag showed a significantly lower frequency of bacterial contamination, with 0.50 percent before and 0.37 percent after introduction of 70 percent isopropyl alcohol. In addition 8000 apheresis PCs were also screened, showing 24 initially positive samples (0.30%).CONCLUSION: The use of the diversion bag and, to a lesser extent, the use of double swabs with 70 percent isopropyl alcohol, led to a reduction of contamination. As expected, predominant contamination with resident skin bacteria was reduced. The combination of diversion bag and new disinfection led to a frequency of initial positive results for pooled five‐donor PCs, which is similar to that of single‐donor apheresis PCs. Furthermore, the bacterial detection system and associated product recall procedures have been shown to be effective in preventing transfusion of contaminated PCs and/or related red cells, especially for rapidly growing bacteria.Keywords
This publication has 23 references indexed in Scilit:
- A new strategy for estimating risks of transfusion‐transmitted viral infections based on rates of detection of recently infected donorsTransfusion, 2005
- Detection of bacterial contamination of platelet components: six years’ experience with the BacT/ALERT systemTransfusion, 2004
- ORIGINAL PAPER. Relative values of the interventions of diversion and improved donor‐arm disinfection to reduce the bacterial risk from blood transfusionVox Sanguinis, 2004
- Transfusion‐transmitted bacterial infectionin the United States, 1998 through 2000Transfusion, 2001
- Determinants of transfusion‐associated bacterial contamination: results of the French Bacthem Case‐Control StudyTransfusion, 2001
- Determination of the degree of bacterialcontamination of whole‐blood collections using anautomated microbe‐detection systemTransfusion, 2001
- Evaluation of an automated culture systemfor detecting bacterial contamination of platelets: an analysis with 15 contaminating organismsTransfusion, 2001
- Septic reactions to platelet transfusions. A persistent problem1991
- Reports of 355 transfusion‐associated deaths: 1976 through 1985Transfusion, 1990
- Storage of Whole Blood for up to 24 Hours at Ambient Temperature prior to Component PreparationVox Sanguinis, 1989