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Transfusion medicine

Tranfusion-transmitted disease

Bacterial contamination in platelet products


Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 31 October 2011, last major update September 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.

General
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● In 2004, the AABB implemented standard 5.1.5.1 that blood collection and transfusion facilities must have some techniques to detect and limit bacterial contamination of platelet products
● Led to significant reduction of bacterial contamination risk in platelets
● Bacterial testing of platelets is required in US and Canada (Transfusion 2007;47:421)
● Bacteria are usually from skin flora (Propionibacterium acnes, Staphylococcus epidermidis)
● Cultures detect only half of contaminated units at median 0.7 days for aerobic cultures or 3.7 days for anaerobic cultures (Transfusion 2007;47:644)
● Reagent strips are inadequate for detection of bacteria (Arch Pathol Lab Med 2004;128:852)
● Photochemical treatment with amotosalen and ultraviolet A may reduce risk (Transfusion 2007;47:1125)
● After implementation of AABB policy, risk of septic reactions is 1 in 75,000 platelet transfusions, risk of death from sepsis is 1 in 500,000 products (50% reduction from pre-AABB policy)
● Bacterial contamination risk is higher for two arm apharesis procedures (Transfusion 2007;47:1134)
● Recommended to divert first 30-50 mL of blood containing skin plug and associated bacteria and to use effective skin disinfection methods (Transfusion 2006;46:476)
● In 2004, CAP added a phase I item to the Laboratory Accreditation Checklist, TRM.44955: “Does the laboratory have a system to detect the presence of bacteria in Platelet components?” (Arch Pathol Lab Med 2004;128:958) and is subject of AABB standard 5.1.5.1 (Arch Pathol Lab Med 2004;128:279)

Case reports
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● Fatal infections (MMWR Morb Mortal Wkly Rep 2005;54:168)
Listeria monocytogenes (Transfusion 2006;46:305), Morganella morganii (Transfus Med 2004;14:237), Streptococcus bovis (Am J Hematol 2004;77:282), Streptococcus pneumoniae (Rinsho Ketsueki 2003;44:381)

End of Transfusion Medicine > Tranfusion-transmitted disease > Bacterial contamination in platelet products


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