Dickson Michelle, Dinesh Dorothy
New Zealand Blood Service, Private Bag 7904, Wellington 6242, New Zealand.
N Z Med J. 2013 May 10;126(1374):12-21.
To identify the rate of bacterial contamination of platelet concentrates in New Zealand and compare with other countries who use the BacT/ALERT screening system. To report on septic transfusion reactions associated with platelet transfusion in New Zealand.
Six mL of platelet concentrate is inoculated into a BacT/ALERT BPA (aerobic culture) bottle on Day 2 post-collection. Bottles that are flagged as positive are sent to the microbiology laboratory, with the associated unit, for confirmatory testing. Platelet units that have expired are sampled again. Results from the four blood processing sites in New Zealand were reviewed.
59,461 (65%) platelet components were sampled on Day 2 and 15,560 (17%) were re-sampled post-expiry, between December 2003 and September 2011. The rate of confirmed bacterial contamination was 0.04% for Day 2 sampling and 0.04% for post-expiry sampling. The rate in the published literature ranges from 0.01-0.74% and is lower (0.01-0.18%) when diversion of the initial flow of blood is utilised. There were five bacterial transfusion transmitted infections associated with platelet transfusion reported during the study period.
BacT/ALERT screening reduces the transfusion of bacterially contaminated platelet concentrates. Day 2 sampling does not identify all contaminated units.
确定新西兰血小板浓缩物的细菌污染率，并与使用BacT/ALERT筛查系统的其他国家进行比较。报告新西兰与血小板输注相关的败血症性输血反应。
在采集后第2天，将6 mL血小板浓缩物接种到BacT/ALERT BPA（需氧培养）瓶中。标记为阳性的瓶子连同相关单位一起送往微生物实验室进行确证检测。对过期的血小板单位再次进行采样。回顾了新西兰四个血液处理站点的结果。
在2003年12月至2011年9月期间，第2天对59,461份（65%）血小板成分进行了采样，过期后对15,560份（17%）进行了重新采样。第2天采样的确诊细菌污染率为0.04%，过期后采样的确诊细菌污染率为0.04%。已发表文献中的污染率范围为0.01 - 0.74%，当采用血液初始流动分流时污染率较低（0.01 - 0.18%）。在研究期间报告了5例与血小板输注相关的细菌输血传播感染。
BacT/ALERT筛查可减少细菌污染的血小板浓缩物的输注。第2天采样不能识别所有受污染的单位。
