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Routine bacterial screening of apheresis platelets on Day 4 using a rapid test: a 4-year single-center experience

Authors

  • Nancy M. Dunbar,

    Corresponding author
    1. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
    2. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
    • Department of Pathology, Department of Medicine, Center for Transfusion Medicine Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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    • These authors contributed equally.
  • Justin D. Kreuter,

    1. Department of Pathology, Department of Medicine, Center for Transfusion Medicine Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
    2. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
    3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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    • These authors contributed equally.
  • Cynthia R. Marx-Wood,

    1. Department of Pathology, Department of Medicine, Center for Transfusion Medicine Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
    2. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
    3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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  • Larry J. Dumont,

    1. Department of Pathology, Department of Medicine, Center for Transfusion Medicine Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
    2. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
    3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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  • Zbigniew M. Szczepiorkowski

    1. Department of Pathology, Department of Medicine, Center for Transfusion Medicine Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
    2. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
    3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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Address reprint requests to: Nancy M. Dunbar, MD, One Medical Center Drive, Lebanon, NH 03756-0001; e-mail: Nancy.M.Dunbar@hitchcock.org.

Abstract

Background

The platelet (PLT) Pan Genera Detection test (PGD) is a rapid bacterial detection system used to screen PLTs for bacterial contamination. We report a single center 46-month experience with secondary screening of apheresis PLTs by PGD testing.

Study Design and Methods

Existing testing records of apheresis PLTs screened by PGD from July 2008 to April 2012 were reviewed. All PLT units were initially screened by routine postcollection culture methods. Secondary screening using PGD was performed for indated PLTs on PLT storage Day 4 and for outdated PLTs on Day 8.

Results

A total of 8535 apheresis PLTs were available in inventory during the study period. Of these, 5030 (58.9%) were dispensed and transfused before PGD testing and 3505 (41.1%) underwent PGD testing on Day 4. Twenty-five units tested on Day 4 were PGD initial reactive (0.71%). All were confirmed to be false positive by repeat PGD testing in triplicate (n = 20) or by confirmatory culture (n = 5). An additional 364 units that were PGD nonreactive on Day 4 were approved for transfusion on Day 6 or Day 7 due to urgent clinical need. A total of 371 outdated units underwent repeat PGD testing before discard on Day 8; all were nonreactive.

Conclusion

Secondary PGD testing of culture-screened apheresis PLTs results in low yield in a medium-sized transfusion service. Use of PGD testing on Day 4 may allow for extension of the apheresis PLT shelf life to Day 7 for hospitals that face supply constraints.

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