Bacterial contamination of peripheral blood progenitor cells for transplantation.
Peripheral blood progenitor cells (PBPC) were obtained from 128 apheresis harvests on 64 patients and were tested in duplicate for microbiological contamination (1) after collection and (2) after thawing, following processing and cryopreservation. In this study we have attempted to improve the monitoring of contamination in peripheral blood progenitor cell collections by identifying exogenous contamination that probably originated from the testing laboratory and is therefore not clinically significant. We found no contamination in 82% of harvests, 1.6% of harvests to be significantly contaminated and organisms were isolated from 16.4% that were assessed as clinically nonsignificant. Our experience indicates that the choice of microbiological methods will influence the results and their clinical relevance. No samples were positive by direct culture. We recommend that sampling should be performed at more than one stage during the procedure and that initially only the post-thaw samples be analysed. Testing should be performed by enrichment culture in duplicate only and if positive to aid interpretation the post-collection sample should then be cultured. No patient given nonsignificantly contaminated graft without antibiotic cover suffered infection from the identified organism. The incidence of significant contamination was low and we recommend that in these cases PBPC grafts can be infused safely provided prophylactic antibiotic cover is given.
Jestice
H K
HK
Department of Clinical Haematology, Addenbrooke's NHS Trust, Cambridge, U.K.
Farrington
M
M
Hunt
C
C
Matthews
I
I
Scott
M A
MA
Foreman
J
J
Marcus
R E
RE
D001431:Bacteriological Techniques; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000382:microbiology*; D006801:Humans; D015983:Selection Bias; D013048:Specimen Handling