Diagnostic methods for platelet bacteria screening: current status and developments

Abstract

Bacterial contamination of blood components and the prevention of transfusion-associated bacterial infection still remains a major challenge in transfusion medicine. Over the past few decades, a significant reduction in the transmission of viral infections has been achieved due to the introduction of mandatory virus screening. Platelet concentrates (PCs) represent one of the highest risks for bacterial infection. This is due to the required storage conditions for PCs in gas-permeable containers at room temperature with constant agitation, which support bacterial proliferation from low contamination levels to high titers. In contrast to virus screening, since 1997 in Germany bacterial testing of PCs is only performed as a routine quality control or, since 2008, to prolong the shelf life to 5 days. In general, bacterial screening of PCs by cultivation methods is implemented by the various blood services. Although these culturing systems will remain the gold standard, the significance of rapid methods for screening for bacterial contamination has increased over the last few years. These new methods provide powerful tools for increasing the bacterial safety of blood components. This article summarizes the course of policies and provisions introduced to increase bacterial safety of blood components in Germany. Furthermore, we give an overview of the different diagnostic methods for bacterial screening of PCs and their current applicability in routine screening processes.

Keywords: Bacterial detection methods; Culture methods; National guidelines Germany; Platelet concentrates; Rapid methods; Screening strategies.

Fig. 1

Overview of the essential German strategies for the prevention of bacterial contamination of blood components and their influence on the rate of transfusion-transmitted bacterial infection (TTBI). Different strategies have been described and published in terms of different votes by of the National Advisory Committee Blood of the German Federal Ministry of Health (Arbeitskreis Blut, AKB). The rate of TTBI was assumed from the German hemovigigilance report published by Funk et al. [10].