Screening of platelet concentrates for bacterial contamination: spectrum of bacteria detected, proportionof transfused units, and clinical follow-up

Gabriele Walther-Wenke (1, 2) , Hubert Schrezenmeier (3) , Robert Deitenbeck (4) , Gabriele Geis (5) , Jürgen Burkhart (6) , Britta Höchsmann (3) , Walid Sireis (7) , Michael Wi Schmidt (7) , Erhard Seifried (7) , Wolfgang Gebauer (8) , Ute-Maja Liebscher (9) , Franz Weinauer (6) , Thomas H. Müller (10)

1 German Red Cross Blood Service West
2 DRK-Blutspendedienst West
3 German Red Cross Blood Service Baden-Wuerttemberg – Hessia and Ost
4 German Red Cross Blood Service West
5 Department of Medical Microbiology
6 Bavarian Red Cross Blood Service
7 German Red Cross Blood Service Baden-Wuerttemberg – Hessia and Ost
8 German Red Cross Blood Service NSTOB
9 German Red Cross Blood Service Baden-Wuerttemberg – Hessia and Ost
10 German Red Cross Blood Service NSTOB

Screening of platelet concentrates (PCs) for bacterial contamination with cultivation methods is carried out as a routine procedure in some countries. The aim is to prevent the transfusion of contaminated PCs. The German Evaluation of Regular Monitoring Study Group conducted a prospective multicenter study on 52,243 PCs to investigate the prevalence of bacteria (BacT/ALERT, bioMerieux). This study describes the detected bacterial spectrum, the proportion of PCs with a positive test result that had been transfused, and the results of the clinical follow-up. One hundred thirteen (67%) of 169 potentially or confirmed positive units had already been transfused at the time of the first positive signal. The transfusion of units contaminated by , , and 73% of the units contaminated with , , or was prevented. In contrast, 85% of units with were transfused. A clonal relationship of the isolates from the pooled PCs and from the associated red blood cell concentrates was found in all investigated cases. The follow-up revealed six febrile reactions to culture-positive PCs not classified as transfusion reaction (TRs) by treating physicians. This demonstrates the importance of hemovigilance. Serious septic reactions due to in two units of one apheresis PC that had tested false-negative were reported; one had a fatal outcome. Culture systems reduce the risk of transfusion of contaminated PCs but cannot guarantee sterility. Physicians must be aware of bacterial contamination of PCs as a potential cause of TRs and must report all adverse events.

Mots clés: Bacterial screening; Platelet concentrates; Contamination; Septic transfusion reaction

Gabriele Walther-Wenke, Hubert Schrezenmeier, Robert Deitenbeck, Gabriele Geis, Jürgen Burkhart, et al.. Screening of platelet concentrates for bacterial contamination: spectrum of bacteria detected, proportionof transfused units, and clinical follow-up. Annals of Hematology, 2009, 89 (1), pp.83-91. ⟨10.1007/s00277-009-0762-2⟩. ⟨hal-00535065⟩