Störmer Melanie, Vollmer Tanja
Institut für Transfusionsmedizin, Blutspendezentrale, Universitätsklinikum Köln, Bad Oeynhausen, Germany.
Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Transfus Med Hemother. 2014 Feb;41(1):19-27. doi: 10.1159/000357651. Epub 2013 Dec 30.
Bacterial contamination of blood components and the prevention of transfusion-associated bacterial infection still remains a major challenge in transfusion medicine. Over the past few decades, a significant reduction in the transmission of viral infections has been achieved due to the introduction of mandatory virus screening. Platelet concentrates (PCs) represent one of the highest risks for bacterial infection. This is due to the required storage conditions for PCs in gas-permeable containers at room temperature with constant agitation, which support bacterial proliferation from low contamination levels to high titers. In contrast to virus screening, since 1997 in Germany bacterial testing of PCs is only performed as a routine quality control or, since 2008, to prolong the shelf life to 5 days. In general, bacterial screening of PCs by cultivation methods is implemented by the various blood services. Although these culturing systems will remain the gold standard, the significance of rapid methods for screening for bacterial contamination has increased over the last few years. These new methods provide powerful tools for increasing the bacterial safety of blood components. This article summarizes the course of policies and provisions introduced to increase bacterial safety of blood components in Germany. Furthermore, we give an overview of the different diagnostic methods for bacterial screening of PCs and their current applicability in routine screening processes.
血液成分的细菌污染以及输血相关细菌感染的预防仍是输血医学中的一项重大挑战。在过去几十年里,由于引入了强制性病毒筛查,病毒感染的传播已大幅减少。血小板浓缩物(PCs)是细菌感染的高风险因素之一。这是因为PCs需要在室温下于透气容器中持续搅拌的储存条件,这有利于细菌从低污染水平增殖至高滴度。与病毒筛查不同,自1997年起在德国,对PCs的细菌检测仅作为常规质量控制进行,或者自2008年起,用于将保质期延长至5天。一般来说,各血液服务机构通过培养方法对PCs进行细菌筛查。尽管这些培养系统仍是金标准,但在过去几年里,快速筛查细菌污染方法的重要性有所增加。这些新方法为提高血液成分的细菌安全性提供了有力工具。本文总结了德国为提高血液成分细菌安全性而出台的政策和规定的历程。此外,我们概述了用于PCs细菌筛查的不同诊断方法及其在常规筛查过程中的当前适用性。