Impact of donor arm skin disinfection on the bacterial contamination rate of platelet concentrates.
OBJECTIVE
Despite improved methods for detecting bacterial contamination of blood products, bacterial sepsis remains a significant risk in blood transfusion. This study was undertaken to investigate whether adopting a different skin disinfection protocol could reduce the rate of bacterial contamination of platelet concentrates.


METHODS
Two skin disinfection protocols were consecutively used in the routine blood collection setting during two 10-month periods: 0.5% cetrimide/0.05% chlorhexidine solution followed by 70% isopropyl alcohol (first 10-month time-period); and 10% povidone-iodine followed by 70% isopropyl alcohol (second 10-month time-period). The rates of bacterial contamination of platelet concentrates were monitored by using a surveillance programme described previously.


RESULTS
The overall bacterial contamination rate in the first time-period was 0.072%. After introduction of the povidone-iodine and isopropyl alcohol protocol, the bacterial contamination rate decreased to 0.042% (relative risk reduction: -0.42; 95% confidence interval, -0.12 to -0.61, P= 0.009). There were no differences in the types of micro-organisms identified (P = 0.7).


CONCLUSIONS
Skin disinfection by povidone-iodine and isopropyl alcohol is more effective than that by cetrimide/chorhexidine and isopropyl alcohol in reducing venepuncture-associated contamination of platelet concentrates by skin flora. Our data indicate that the disinfection protocol should be used on a routine basis and such implementation should translate into a significant improvement in blood safety to patients receiving platelet transfusion.
D019840:2-Propanol / Q000494:pharmacology; D001132:Arm; D001424:Bacterial Infections / Q000517:prevention & control / Q000635:transmission*; D001782:Blood Donors; D001792:Blood Platelets / Q000382:microbiology; D001800:Blood Specimen Collection; D000077286:Cetrimonium; D002593:Cetrimonium Compounds / Q000494:pharmacology; D004202:Disinfectants / Q000494:pharmacology; D004203:Disinfection / Q000379:methods*; D006801:Humans; D017713:Platelet Transfusion / Q000009:adverse effects*; D011206:Povidone-Iodine / Q000494:pharmacology; D012867:Skin / Q000382:microbiology
D002593:Cetrimonium Compounds; D004202:Disinfectants; D011206:Povidone-Iodine; D019840:2-Propanol; D000077286:Cetrimonium