Bacterial contamination of platelet concentrates: results of a prospective multicenter study comparing pooled whole blood–derived platelets and apheresis platelets

Authors

  • Hubert Schrezenmeier,

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    • *

      HS and GWW equally contributed to this article.

  • Gabriele Walther-Wenke,

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    • *

      HS and GWW equally contributed to this article.

  • Thomas H. Müller,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Franz Weinauer,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Adelheid Younis,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Tim Holland-Letz,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Gabriele Geis,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Jens Asmus,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Ursula Bauerfeind,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Jürgen Burkhart,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Robert Deitenbeck,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Elisabeth Förstemann,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Wolfgang Gebauer,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Britta Höchsmann,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Apostolos Karakassopoulos,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Ute-Maja Liebscher,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Werner Sänger,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Michael Schmidt,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Friedrich Schunter,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Walid Sireis,

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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  • Erhard Seifried

    1. This study was conducted by the GERMS (German Evaluation of Regular Monitoring Study) Group of the Red Cross Transfusion Services (see Acknowledgments).
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Hubert Schrezenmeier, MD, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, Red Cross Blood Donor Service Baden-Württemberg–Hessia, and Institute of Transfusion Medicine, University of Ulm, Helmholtzstrasse 10, 89081 Ulm, Germany; e-mail: h.schrezenmeier@blutspende.de.

Abstract

BACKGROUND: The GERMS Group initiated a prospective multicenter study to assess prevalence and nature of bacterial contamination of pooled buffy-coat platelet concentrates (PPCs) and apheresis platelet concentrates (APCs) by routine screening with a bacterial culture system.

STUDY DESIGN AND METHODS: In nine centers overall, 52,243 platelet (PLT) concentrates (15,198 APCs, 37,045 PPCs) were analyzed by aerobic and anaerobic cultures (BacT/ALERT, bioMérieux).

RESULTS: In 135 PLT concentrates (PCs; 0.26%), bacteria could be identified in the first culture (0.4% for APCs vs. 0.2% for PPCs; p < 0.001). In 37 (0.07%) of these PC units, the same bacteria strain could be identified in a second culture from the sample bag and/or the PC unit. The rate of confirmed-positive units did not differ significantly between APC (0.09%; 1/1169) and PPC units (0.06%; 1/1544). Bacteria from skin flora (Propionibacterium acnes, Staphylococcus epidermidis) were the most prevalent contaminants. Median times to first positive culture from start of incubation were 0.7 and 3.7 days in aerobic and anaerobic cultures for confirmed-positive units. With a “negative-to-date” issue strategy, most PC units (55%) had already been issued by time of the first positive culture.

CONCLUSION: The rate of confirmed bacterial contamination of PC units was low. Nevertheless, clinicians must be aware of this risk. The risk of bacterial contamination does not warrant universal preference of APCs. It must be questioned whether routine bacterial screening by a culture method can sufficiently prevent contaminated products from being transfused due to the delay until a positive signal in the culture system and due to false-negative results.

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