Bacterial risk reduction by improved donor arm disinfection, diversion and bacterial screening.

The Interventions of improved donor arm disinfection, diversion and bacterial screening have been implemented by blood services and shown to have substantial benefit. The major source of bacterial contamination is donor arm derived. Blood services are now introducing best practice donor arm disinfection techniques. Diversion has been shown to substantially reduce bacterial contamination in the order of 40-88%. Diversion, together with improved donor arm disinfection, has shown to improve the percentage of reduction in contamination from 47% to 77%. Residual contamination levels after the Introduction of diversion and improved donor arm disinfection may be in the order of 30-40%. Numerous countries have now implemented screen testing programmes for platelet concentrates, which are the major source of bacterial transfusion transmission. Pathogen reduction systems have been developed and are under development. At present, concerns remain with these systems regarding cost, process control, ability to inactivate high titres of viruses, killing of bacterial spores, product damage, genotoxicity and mutagenicity. The interventions of diversion, improved donor arm disinfection and bacterial screen testing are currently available, As such they can be implemented now to increase blood safety with no associated patient risk.