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Screening platelet concentrates for bacterial contamination: low numbers of bacteria and slow growth in contaminated units mandate an alternative approach to product safety
Author(s) -
Murphy W. G.,
Foley M.,
Doherty C.,
Tierney G.,
Kinsella A.,
Salami A.,
Cadden E.,
Coakley P.
Publication year - 2008
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.2008.01051.x
Subject(s) - contamination , mandate , bacteria , blood product , product (mathematics) , microbiology and biotechnology , biology , medicine , mathematics , surgery , political science , ecology , genetics , geometry , law
Background and Objectives We introduced 100% screening of platelets for bacterial contamination in 2005 to reduce the risk of clinical sepsis from platelet transfusion. We test all outdating units again at expiry to assess the sensitivity of the initial test. Materials and Methods We test all platelet concentrates prior to release for clinical use using a large volume automated culture technique on the day after manufacture. All units that expire unused are retested. Platelets still in stock on day 4 of storage may have a repeat culture performed, and are returned to stock with two extra days of shelf life. Results Of 43 230 platelet units screened, 35 (0·08%) were positive; of 8282 expired unused, 18 (0·22%) were positive; and of 3310 day‐4 retests, four (0.12%) were positive. Overall sensitivity of the initial screening test was 29·2% (95% confidence interval 19·4 to 39·1%). Thirteen of the 35 positive screening tests would have been expected to grow in both aerobic and anaerobic bottles; eight grew in aerobic culture only and five grew in anaerobic culture only, indicating that the likely number of bacteria in the contaminated platelet units at the time of sampling was less than 60 colony‐forming unit per platelet unit. Conclusions Screening platelet concentrates for bacterial contamination using the most sensitive method available has a sensitivity of less than 40% because of the low numbers of bacteria in the initial contamination. Effective resolution of this problem will require a pathogen‐inactivation technique.