Analysis of bacterial detection in whole blood-derived platelets by quantitative glucose testing at a university medical center.
After the March 2004 implementation of American Association of Blood Banks standards regarding platelet bacterial detection, we began quantitative glucose screening of whole blood-derived platelets (WB-P). The glucose level was measured immediately before component release--often storage day 4 or 5--using the Glucometer SureStep Flexx Meter (LifeScan, Milpitas, CA), with a positive cutoff of less than 500 mg/dL; failing units were cultured and not transfused. During 29 months (March 1, 2004-July 31, 2006) 93,073 units of WB-P were tested. Initially, 929 units (0.998%) screened positively. Bacterial growth was culture-confirmed in 6 units, for a bacterial contamination incidence of 0.006% and a true-positive rate of 6.4/100,000. Three additional culture-confirmed contamination cases were detected in transfused units causing febrile nonhemolytic reactions, for a false-negative rate of 3.2/100,000. Our overall contamination prevalence was 9.6/100,000 units of platelets transfused, lower than ordinarily cited, and showed a false-negative rate remarkably congruent to that of culture: 3.2/100,000. A low-sensitivity screening test applied late in platelet shelf-life can be comparable to culture in preventing bacterial-related morbidity.
McKane
A Victoria
AV
Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE/MMC 609, Minneapolis, MN 55455, USA.
Ward
Nancy
N
Senn
Chris
C
Eubanks
Julie
J
Wessels
Linda
L
Bowman
Robert
R
D000046:Academic Medical Centers; D000328:Adult; D001424:Bacterial Infections / Q000209:etiology*; D001792:Blood Platelets / Q000382:microbiology*; D005947:Glucose / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects*; D011785:Quality Assurance, Health Care
D005947:Glucose