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Tackling the Problem of Bacterial Contamination
Author(s) -
AuBuchon James P
Publication year - 2005
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.2005.00554c.x
Subject(s) - contamination , platelet transfusion , medicine , sepsis , intensive care medicine , transmission (telecommunications) , human immunodeficiency virus (hiv) , platelet , immunology , biology , computer science , ecology , telecommunications
Focus on the risks of viral transmission via transfusion has pushed recognition of other transfusion risks to the background over the last several decades. With reduction in the risks of HCV and HIV to very low levels (well less than 1/million units), productive attention can now be directed toward other risks. Bacterial contamination of platelets represents the largest morbidity and mortality risk faced by a platelet recipient, and the risk of dieing due to a contaminated unit is at least 10‐ if not 100‐times greater than the chance of HIV transmission. Approximately 1 in every 1–4,000 units of platelets can be shown to contain bacteria, and the frequency of fatality due to port‐transfusion sepsis is 14/million units transfused. Bacterial contamination is often not recognized clinically, however, because of the situation of the patient. A variety of techniques to limit and detect bacterial contamination are available for implementation. Culturing is used most widely. Checking pH, glucose concentration or preservation of swirling are simple and inexpensive techniques but suffer from lack of sensitivity. The development of immunologic techniques that can be accomplished rapidly may shift the testing to immediately before issuance for transfusion, a time at which any contamination would be easier to detect because of growth during the storage period. Not only will detection techniques improve transfusion recipient safety, but they can lead to cost‐savings through extension of the platelet storage period as has already been implemented in several European countries.