[Transfusion-transmitted bacterial infection: residual risk and perspectives of prevention].
Bacterial contamination of blood components represents today the highest infectious risk of blood transfusion, the risk is particularly high when it affects platelet concentrates. The residual risk of transfusion reaction due to bacterial contamination of platelets concentrates remains stable. For all severity 1 case occurs with 25,000 distributed platelets concentrates and 1 death occurs with 200,000 distributed units. In France, efforts have focused on the prevention of contamination during donation--involving measures such as rejecting the first few millilitres of donated blood and improving skin disinfection--and the prevention of bacterial proliferation in platelets concentrates--notably by removing leukocytes and ensuring high-quality storage of donated blood. Improving strategies for reducing the risks of bacterial contamination is one of the priorities of the French National Blood Transfusion Service (l'Etablissement français du sang-EFS). There is currently considerable debate about the relative importance of bacterial screening methods and methods for inactivating pathogens present in PC. Automated culture (Biomérieux) and the ScanSystem (Hemosystem) and BDS (Pall) method are the most advanced detection systems available, to our knowledge. In term of pathogen inactivation system for platelets, Intercept (Baxter) is nearing the commercial market. These new prevention have logistic and/or functional consequences that will require close scrutiny methods. A national study group is currently considering the consequences of each of these methods and should give its opinion at the end of the first half of 2003.
Morel
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P
Etablissement français du sang Bourgogne-Franche-Comté, 1, boulevard A.-Fleming, 25020 cedex, Besançon, France. pascal.morel@efs.sante.fr <pascal.morel@efs.sante.fr>
Deschaseaux
M
M
Bertrand
X
X
Naegelen
C
C
Talon
D
D
D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D001803:Blood Transfusion / Q000592:standards; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D065227:Transfusion Reaction