Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactions
- 30 June 2018
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 58 (7), 1647-1653
- https://doi.org/10.1111/trf.14618
Abstract
BACKGROUNDBacterial contamination of platelets remains a major transfusion-associated risk despite long-standing safety measures in the United States. We evaluated an approach using secondary bacterial culture (SBC) to contend with residual risk of bacterial contamination. STUDY DESIGN AND METHODSPhased implementation of SBC was initiated in October 2016 for platelets (all apheresis collected) received at our institution from the blood donor center (Day 3 post collection). Platelet products were sampled aseptically (5 mL inoculated into an aerobic bottle [BacT/ALERT BPA, BioMerieux, Inc.]) by the blood bank staff upon receipt, using a sterile connection device and sampling kit. The platelet sample was inoculated into an aerobic blood culture bottle and incubated at 35 degrees C for 3 days. The cost of SBC was calculated on the basis of consumables and labor costs at time of implementation. RESULTSIn the 13 months following implementation (October 6, 2016, to November 30, 2017), 23,044/24,653 (93.47%) platelet products underwent SBC. A total of eight positive cultures were detected (incidence 1 in 2881 platelet products), seven of which were positive within 24 hours of SBC. Coagulase negative Staphyloccus spp. were identified in four cases. Five of the eight cases were probable true positive (repeat reactive) and interdicted (cost per averted case was US$77,935). The remaining three cases were indeterminate. No septic transfusion reactions were reported during the observation period. CONCLUSIONWe demonstrate the feasibility of SBC of apheresis platelets to mitigate bacterial risk. SBC is lower cost than alternative measures (e.g., pathogen reduction and point-of-release testing) and can be integrated into workflow at hospital transfusion services.Keywords
Funding Information
- Johns Hopkins Hospital Transfusion Medicine Division
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