Michael Schmidt1, Walid Sireis, Erhard Seifried. 1. German Red Cross, Institute for Transfusion Medicine and Immunohaematology, Johann Wolfgang Goethe University, Frankfurt/M., Germany.
Abstract
SUMMARY: BACKGROUND: Through the implementation of modern technology, such as nucleic acid testing, over the last two decades, blood safety has improved considerably in that the risk of viral infection is less than 1 in a million blood transfusions. By contrast, the residual risk of transfusion-associated bacterial infection is stable at approximately 1 in 2,000 to 1 in 3,000 in platelets. To improve blood safety with regard to bacterial infections, many countries have implemented bacterial screening methods as part of their blood donor screening programmes. METHODS: BACTERIAL DETECTION METHODS ARE CLUSTERED INTO THREE GROUPS: i) culture methods in combination with the 'negative-to-date' concept, ii) rapid detection systems with a late sample collection, and iii) bedside screening tests. RESULTS: The culture methods are convincing because of their very high analytical sensitivity. Nevertheless, false-negative culture results and subsequent fatalities were reported in several countries. Rapid bacterial systems are characterised as having short testing time but reduced sensitivity. Sample errors are prevented by late sample collection. Finally, bedside tests reduce the risk for sample errors to a minimum, but testing outside of blood donation services may have risks for general testing failures. CONCLUSION: Bacterial screening of blood products, especially platelets, can be performed using a broad range of technologies. Each system exhibits advantages and disadvantages and offers only a temporary solution until a general pathogen inactivation technology is available for all blood components.
SUMMARY: BACKGROUND: Through the implementation of modern technology, such as nucleic acid testing, over the last two decades, blood safety has improved considerably in that the risk of viral infection is less than 1 in a million blood transfusions. By contrast, the residual risk of transfusion-associated bacterial infection is stable at approximately 1 in 2,000 to 1 in 3,000 in platelets. To improve blood safety with regard to bacterial infections, many countries have implemented bacterial screening methods as part of their blood donor screening programmes. METHODS: BACTERIAL DETECTION METHODS ARE CLUSTERED INTO THREE GROUPS: i) culture methods in combination with the 'negative-to-date' concept, ii) rapid detection systems with a late sample collection, and iii) bedside screening tests. RESULTS: The culture methods are convincing because of their very high analytical sensitivity. Nevertheless, false-negative culture results and subsequent fatalities were reported in several countries. Rapid bacterial systems are characterised as having short testing time but reduced sensitivity. Sample errors are prevented by late sample collection. Finally, bedside tests reduce the risk for sample errors to a minimum, but testing outside of blood donation services may have risks for general testing failures. CONCLUSION: Bacterial screening of blood products, especially platelets, can be performed using a broad range of technologies. Each system exhibits advantages and disadvantages and offers only a temporary solution until a general pathogen inactivation technology is available for all blood components.
Authors: Michael R Jacobs; Saralee Bajaksouzian; Anne Windau; Elizabeth L Palavecino; Roslyn Yomtovian Journal: Transfusion Date: 2005-02 Impact factor: 3.157
Authors: Stein Holme; Morven B McAlister; Girolamo A Ortolano; Chiyong Chong; Mary Anne Cortus; Michael R Jacobs; Roslyn Yomtovian; Lawrence F Freundlich; Barry Wenz Journal: Transfusion Date: 2005-06 Impact factor: 3.157