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欧洲血小板浓缩物的微生物学筛查

Microbiological Screening of Platelet Concentrates in Europe.

作者信息

Prax Marcel, Bekeredjian-Ding Isabelle, Krut Oleg

机构信息

Division of Microbiology, Paul Ehrlich Institute, Langen, Germany.

出版信息

Transfus Med Hemother. 2019 Apr;46(2):76-86. doi: 10.1159/000499349. Epub 2019 Mar 20.

Abstract

The risk of transfusion-associated sepsis due to transmission of bacteria is a persistent problem in the transfusion field. Despite numerous interventions to reduce the risk, cases of bacterial sepsis following transfusion are repeatedly being reported. Especially platelet concentrates are highly susceptible to bacterial contaminations due to the growth-promoting storage conditions. In Europe, blood establishments and national authorities have implemented individual precaution measures to mitigate the risk of bacterial transmission. To obtain an overview of the different approaches, we compiled information from national authorities, blood establishments, and the current literature. Several aspects such as the shelf life of platelets, time of sampling and the applied control measures are compared between the member states. The analysis of the data revealed a broad heterogeneity of procedures on a national level ranging from platelet release without any safety testing up to mandatory screening of all platelet concentrates prior to transfusion. Despite the substantial progress made in recent years, several bacterial reports on transfusion-associated sepsis indicate that further efforts are needed to increase the safety of blood transfusions in the long term.

摘要

因细菌传播导致的输血相关败血症风险是输血领域长期存在的问题。尽管采取了众多降低风险的干预措施,但输血后细菌性败血症病例仍屡有报道。特别是血小板浓缩物由于促进生长的储存条件,极易受到细菌污染。在欧洲,血液机构和国家当局已实施了个别预防措施以降低细菌传播风险。为全面了解不同方法,我们收集了来自国家当局、血液机构和当前文献的信息。对各成员国之间血小板的保质期、采样时间和应用的控制措施等几个方面进行了比较。数据分析显示,国家层面的程序存在广泛异质性,从无需任何安全检测就放行血小板到输血前对所有血小板浓缩物进行强制筛查不等。尽管近年来取得了重大进展,但几起关于输血相关败血症的细菌报告表明,从长远来看,仍需进一步努力提高输血安全性。

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