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- Title
Extension of platelet shelf life with an improved bacterial testing algorithm.
- Authors
Ramirez‐Arcos, Sandra; Evans, Stephanie; McIntyre, Terri; Pang, Christopher; Yi, Qi‐Long; DiFranco, Caesar; Goldman, Mindy; Ramirez-Arcos, Sandra; Yi, Qi-Long
- Abstract
<bold>Background: </bold>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.<bold>Study Design and Methods: </bold>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 After implementation, from August 2017 to December 2019, a total of 223 156 pools and 39 725 apheresis units and 5310 outdated PCs were screened.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.<bold>Results: </bold>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 Approximately, 1-in-1000 false-negative screening results were obtained during testing of outdated PCs.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%.<bold>Conclusion: </bold>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.
- Subjects
CANADA; ALGORITHMS; KLEBSIELLA oxytoca; SERRATIA marcescens; BLOOD platelets; KLEBSIELLA pneumoniae; RESEARCH; BACTERIOLOGY technique; TIME; RESEARCH methodology; BLOOD collection; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; RESEARCH funding; BACTERIA
- Publication
Transfusion, 2020, Vol 60, Issue 12, p2918
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.16112