Mark H Yazer1, Darrell J Triulzi. 1. Institute for Transfusion Medicine and Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. myazer@itxm.org
Abstract
BACKGROUND: Bacterial contamination of blood products is a leading cause of transfusion-related morbidity and mortality. Transfusion services are now compelled to employ methods of detecting bacteria in platelet (PLT) components. The use of pH screening of whole-blood PLTs (WBPs) was evaluated with a pH meter at the time of issue as a surrogate test for bacterial contamination. STUDY DESIGN AND METHODS: All WBPs selected for transfusion in May through September 2004 were tested individually for pH at time of issue. Those with a pH value of less than 7.0 were cultured in an automated culture system for 5 days. The white blood cell (WBC) and PLT counts in 56 representative WBP units that failed pH screening were compared to WBP units with acceptable pH values. RESULTS: Of the 37,060 WBP units that underwent pH screening, 405 had a pH value of less than 7.0 (1.1%). Four of those units were culture positive (1.0%) for Staphylococcus aureus, Bacillus subtilis, diphtheroids, and coagulase-negative Staphylococcus. Only one cocomponent red blood cell (RBC) unit was culture-positive and grew the same bacteria (S. aureus) as the WBP unit. The rate of pH failure increased with WBP storage length with the greatest rate of pH failures occurring in 5-day-old WBPs. The units that failed pH screening had significantly more WBCs and PLTs than units with acceptable pH values. CONCLUSION: pH screening of WBPs at issue prevented transfusion of bacterially contaminated WBPs and RBCs. This method, however, results in significant PLT wastage. Higher WBC and PLT content likely explains pH failures not due to bacterial contamination.
BACKGROUND: Bacterial contamination of blood products is a leading cause of transfusion-related morbidity and mortality. Transfusion services are now compelled to employ methods of detecting bacteria in platelet (PLT) components. The use of pH screening of whole-blood PLTs (WBPs) was evaluated with a pH meter at the time of issue as a surrogate test for bacterial contamination. STUDY DESIGN AND METHODS: All WBPs selected for transfusion in May through September 2004 were tested individually for pH at time of issue. Those with a pH value of less than 7.0 were cultured in an automated culture system for 5 days. The white blood cell (WBC) and PLT counts in 56 representative WBP units that failed pH screening were compared to WBP units with acceptable pH values. RESULTS: Of the 37,060 WBP units that underwent pH screening, 405 had a pH value of less than 7.0 (1.1%). Four of those units were culture positive (1.0%) for Staphylococcus aureus, Bacillus subtilis, diphtheroids, and coagulase-negative Staphylococcus. Only one cocomponent red blood cell (RBC) unit was culture-positive and grew the same bacteria (S. aureus) as the WBP unit. The rate of pH failure increased with WBP storage length with the greatest rate of pH failures occurring in 5-day-old WBPs. The units that failed pH screening had significantly more WBCs and PLTs than units with acceptable pH values. CONCLUSION: pH screening of WBPs at issue prevented transfusion of bacterially contaminated WBPs and RBCs. This method, however, results in significant PLT wastage. Higher WBC and PLT content likely explains pH failures not due to bacterial contamination.
Authors: Anna Maria Leo; Maria Monica Salvadego; Maria Grazia Piva; Graziano Ruffato; Sara Valverde; Ernesto Trabuio; Francesco Antico; Gianluca Gessoni Journal: Blood Transfus Date: 2007-07 Impact factor: 3.443