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Extension of platelet shelf life with an improved bacterial testing algorithm
Author(s) -
RamirezArcos Sandra,
Evans Stephanie,
McIntyre Terri,
Pang Christopher,
Yi QiLong,
DiFranco Caesar,
Goldman Mindy
Publication year - 2020
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16112
Subject(s) - staphylococcus epidermidis , apheresis , klebsiella oxytoca , medicine , microbiology and biotechnology , staphylococcus aureus , staphylococcus , klebsiella pneumoniae , colony forming unit , serratia marcescens , bacteria , biology , platelet , escherichia coli , biochemistry , genetics , gene
Background At Canadian Blood Services, platelet concentrate (PC) shelf life was extended to 7 days with a large‐volume, delayed‐sampling bacterial screening algorithm. We present the development study and postimplementation results. Study Design and Methods In the development study, PCs inoculated with five bacteria (various concentrations) were incubated for 7 days with daily sampling for BacT/ALERT cultures and bacterial quantification. After implementation, from August 2017 to December 2019, a total of 223 156 pools and 39 725 apheresis units and 5310 outdated PCs were screened. Since March 2018, cocomponents associated to false‐positive results have been released to inventory. Results In the development study, Klebsiella pneumoniae , Serratia marcescens, and Staphylococcus aureus were detected at concentrations of at least 0.01 colony‐forming units (CFUs)/mL at 24 hours postinoculation. However, Staphylococcus epidermidis was detected at concentrations of less than 0.16 CFUs/mL only more than 48 hours postinoculation. After implementation, 776 (0.35%) and 303 (0.77%) initial‐positive results and 201 (0.09%) and 16 (0.04%) confirmed‐positive results were obtained for pools and apheresis units, respectively, predominantly with Cutibacterium acnes . Other organisms included staphylococci, streptococci, Klebsiella oxytoca and Pseudomonas aeruginosa . One nonfatal reaction involving a 7‐day pool contaminated with S. epidermidis occurred . Approximately, 1‐in‐1000 false‐negative screening results were obtained during testing of outdated PCs. Approximately 1000 cocomponents associated with false‐positive results were released into inventory. Combined PC outdating at Canadian Blood Services and hospitals was reduced from 18.9% to 13.1%. Conclusion Screening of 7‐day PCs increased bacterial detection mainly of anaerobes and reduced outdating. The incidence of septic transfusion events has decreased approximately threefold. A longer surveillance period is needed to evaluate the value of anaerobic cultures and residual safety risk.