Bacterial testing of platelets - has it prevented transfusion-transmitted bacterial infections in Australia?
- 1 January 2018
- journal article
- research article
- Published by Wiley in Vox Sanguinis
- Vol. 113 (1), 13-20
- https://doi.org/10.1111/vox.12561
Abstract
Background and ObjectivesAustralia introduced bacterial contamination screening (BCS) for platelet components in April 2008. This study presents analysis performed to assess the efficacy of testing. Materials and MethodsSeven-day aerobic and anaerobic culture is performed using the BacT/ALERT 3D system. Following an initial machine positive (IMP) flag, all associated components are recalled, and/or clinicians treating already transfused patients are notified. IMPs are categorized as machine false positive', confirmed positive' or indeterminate' depending on culture results of initial and repeat samples. ResultsBetween 2010 and 2012, 11% of platelet donations tested IMP; since 2013, this rate has fallen to 06% through improved instrument management, reducing false-positive IMPs but maintaining sensitivity for cultures yielding bacterial growth. On average, 66% of confirmed positive and indeterminate platelet units had been transfused at the time of detection. The majority (95%) of these grew Propionibacterium sp., a slow-growing organism that rarely causes sepsis in the transfusion setting. The incidence of reported transfuion-transmitted bacterial infection (TTBI) has fallen since the introduction of BCS, with a 42-fold [05, 282] lower rate from platelets. ConclusionBCS has been successful in detecting platelet units containing pathogenic bacteria. The incidence of TTBI from platelets has fallen since the introduction of BCS, but the risk has not been eliminated due to rare false-negative results. In the absence of a pathogen inactivation system for red blood cells, BCS provides surrogate' testing of red blood cells from which platelets have been manufactured.Keywords
Funding Information
- National Blood Foundation
This publication has 22 references indexed in Scilit:
- Bacterial survival and distribution during buffy coat platelet productionVox Sanguinis, 2016
- Bacterial contamination in platelet concentratesVox Sanguinis, 2014
- Bacterial culture of apheresis platelets: a mathematical model of the residual rate of contamination based on unconfirmed positive resultsVox Sanguinis, 2013
- Bacterial Pre-Release Testing of Platelets – the Australian Red Cross Blood Service Clinical ExperienceTransfusion Medicine and Hemotherapy, 2011
- BLOOD COMPONENTS: Screening of single‐donor apheresis platelets for bacterial contamination: the PASSPORT study resultsTransfusion, 2010
- Streptococcus pneumoniaesepticemia associated with red blood cell transfusionTransfusion, 2008
- Propionibacterium acnes lacks the capability to proliferate in platelet concentratesVox Sanguinis, 2007
- Bacterial contamination of platelet concentrates: results of a prospective multicenter study comparing pooled whole blood–derived platelets and apheresis plateletsTransfusion, 2007
- Fatal Clostridium perfringens sepsis from a pooled platelet transfusionTransfusion Medicine, 1998
- Platelet transfusion‐related sepsisAustralian and New Zealand Journal of Medicine, 1993