Silva Marianne A, Gregory Kay R, Carr-Greer M Allene, Holmberg Jerry A, Kuehnert Matthew J, Brecher Mark E
UCLA Medical Center, Los Angeles, California, USA.
Transfusion. 2006 Apr;46(4):636-41. doi: 10.1111/j.1537-2995.2006.00768.x.
New voluntary standards in the United States regarding bacterial contamination of platelets (PLTs) led to the formation of the AABB Interorganizational Task Force on Bacterial Contamination of Platelets. This article summarizes a survey conducted by the Task Force to assess the impact of bacterial detection.
An Internet-based survey of AABB member institutions was conducted from September 17, 2004, to October 1, 2004. The survey was designed principally to assess PLT usage, supply, and outdating and the currently used bacteria detection methods.
Of 900 facilities surveyed, 350 responded (38%). These facilities collected approximately 43.3 and 65.9 percent and transfused approximately 19.1 and 22.2 percent of the whole blood-derived PLT concentrates (WBPCs) and apheresis PLTs in the United States, respectively. Most facilities (64-91%) indicated that their ability to provide PLTs for transfusion had not been affected. Approximately half (50-57.1%) indicated no changes in their PLT inventory. Two-thirds (66-68%) indicated no increased PLT outdating. More than 90 percent of apheresis PLTs are tested with a culture-based method, whereas WBPCs are tested with a variety of methods (mostly non-culture-based) resulting in a 4.6-fold decrease in the confirmed positive detection rate compared with apheresis PLTs (p < 0.001).
After the implementation of AABB Standard 5.1.5.1, the majority of facilities responding to this survey experienced no (or modest) impact on PLT availability or outdating. Nevertheless, a substantial portion of facilities experienced both increased outdating and decreased availability. Some facilities were greatly impacted. Based on the data gathered, it is impossible to conclude whether such shortages resulted from production or distribution problems or were due to decreased shelf life and increased outdates.
美国关于血小板(PLT)细菌污染的新自愿性标准促使成立了AABB血小板细菌污染跨组织特别工作组。本文总结了该特别工作组为评估细菌检测影响而开展的一项调查。
2004年9月17日至10月1日对AABB成员机构进行了一项基于互联网的调查。该调查主要旨在评估血小板的使用、供应、过期情况以及当前使用的细菌检测方法。
在调查的900家机构中,350家做出了回应(38%)。这些机构分别采集了美国约43.3%和65.9%的全血来源血小板浓缩物(WBPC)和单采血小板,并分别输注了约19.1%和22.2%。大多数机构(64% - 91%)表示其提供用于输血的血小板的能力未受影响。约一半(50% - 57.1%)表示其血小板库存未发生变化。三分之二(66% - 68%)表示血小板过期情况未增加。超过90%的单采血小板采用基于培养法检测,而全血来源血小板浓缩物采用多种方法检测(大多为非培养法),与单采血小板相比,确诊阳性检出率降低了4.6倍(p < 0.001)。
在实施AABB标准5.1.5.1后,参与本次调查的大多数机构在血小板供应或过期方面未受到(或受到适度)影响。然而,相当一部分机构经历了过期增加和供应减少的情况。一些机构受到了极大影响。根据收集到的数据,无法确定此类短缺是由生产或分发问题导致,还是由于保质期缩短和过期增加所致。