Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium.
KU Leuven, Department of Microbiology, Immunology and Transplantation, Leuven, Belgium.
Blood Transfus. 2020 Sep;18(5):348-358. doi: 10.2450/2020.0108-20. Epub 2020 Aug 6.
Bacterial contamination of blood for transfusion is rarely investigated in low-income countries. We determined the contamination rate of blood products in the Democratic Republic of the Congo.
In this prospective observational study, blood products in one rural and two urban hospitals (paediatric and general) contained a satellite sampling bag by which blood was sampled for culture in a blood culture bottle (4 mL) and on an agar-coated slide to estimate colony forming units (CFU/mL). Bacteria were identified with biochemical tests and MALDI-TOF (Bruker). Exposure time >10 °C was assessed on a subset of blood products.
In total, 1.4% (41 of 2,959) of blood products were contaminated with 48 bacterial isolates. Skin (e.g., Staphylococcus spp.) and environmental (e.g., Bacillus spp.) bacteria predominated (97.8% of 45 isolates identified). Bacterial counts were ≤10 CFU/mL. Contamination rates for the urban paediatric, urban general and rural hospitals were 1.6%, 2.4% and 0.3%, respectively (p=0.004). None of the following variables was significantly associated with contamination: (i) donor type (voluntary 1.6%, family 1.2%, paid 3.9%); (ii) type of blood product (red cells 1.6%, whole blood 0.6%); (ii) season (dry season 2.4%, rainy season 1.8%); (iv) age of blood product (contaminated 8 days vs non-contaminated 6 days); and (v) exposure time >10 °C (median for contaminated and non-contaminated blood reached maximum test limit of 8 hours).
A bacterial contamination rate of 1.4% of whole blood and red cells is similar to results from high-income countries. Implementation of feasible risk-mitigation measures is needed.
在低收入国家，很少对输血用血液的细菌污染进行调查。我们确定了刚果民主共和国血液制品的污染率。
在这项前瞻性观察研究中，一家农村和两家城市医院（儿科和综合科）的血液制品中包含一个卫星采样袋，通过该采样袋对血液进行培养，将血液采样到血培养瓶（4 毫升）和琼脂涂层载玻片上，以估计菌落形成单位（CFU/mL）。细菌通过生化试验和基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）（布鲁克）进行鉴定。对血液制品的亚组评估了暴露时间＞10°C的情况。
总共 1.4%（2959 个中的 41 个）的血液制品受到 48 个细菌分离株的污染。皮肤（如金黄色葡萄球菌）和环境（如芽孢杆菌）细菌占主导地位（45 个鉴定的分离株中有 97.8%）。细菌计数≤10 CFU/mL。城市儿科、城市综合和农村医院的污染率分别为 1.6%、2.4%和 0.3%（p=0.004）。以下变量均与污染无显著相关性：（i）供体类型（自愿 1.6%、家庭 1.2%、有偿 3.9%）；（ii）血液制品类型（红细胞 1.6%、全血 0.6%）；（iii）季节（旱季 2.4%、雨季 1.8%）；（iv）血液制品的年龄（污染的 8 天与未污染的 6 天）；（v）暴露时间＞10°C（污染和未污染血液的中位数达到 8 小时的最大测试限制）。
全血和红细胞的细菌污染率为 1.4%，与高收入国家的结果相似。需要实施可行的风险缓解措施。
