title: Prospective evaluation of 2% (w/v) alcoholic chlorhexidine gluconate as an antiseptic agent for blood donor arm preparation.
abstract: OBJECTIVE
  A prospective study was undertaken to evaluate the use of 2% (w/v) alcoholic chlorhexidine gluconate (2% AlcCHG) in donor arm preparation, to monitor the contamination rate of blood products after the collection and to find incidence of transfusion associated bacteremia.
  
  
  METHODS
  Optimal skin antisepsis of the phlebotomy site is essential to minimize the risk of contamination. Food and Drug Administration (FDA) in India has recommended antisepsis with three-step regimen of spirit-10% povidone iodine-spirit for donor arm antisepsis, but not with chlorhexidine, which is recommended by many other authors.
  
  
  METHODS
  A total of 795 donors were studied from July 2011 to January 2012. Spirit-10% povidone iodine-spirit was used for 398 donors and 2% AlcCHG was used for 397 donors with the two-step method for arm antisepsis. Swabs were collected before and after use of antiseptic agents for all the donors. All the blood products collected from donors with growth in post-antisepsis swabs were cultured. A total of 123 various blood products were cultured irrespective of the method and result of antisepsis was observed. A total of seven patients had mild transfusion reaction. The transfused blood products, blood and urine specimen of the patients who had transfusion reaction were also cultured.
  
  
  RESULTS
  Seven donors out of 398 donors had growth in post-antisepsis swab with spirit-10% povidone iodine-spirit protocol and three donors out of 397 donors had growth in post-antisepsis swab with 2% AlcCHG protocol. All blood products collected from donors who had growth in post-antisepsis swabs when cultured had no growth. There was no contamination of blood products.
  
  
  CONCLUSIONS
  Two percent (w/v) alcoholic chlorhexidine gluconate with two-step protocol can be used as an antiseptic agent for donor arm preparation without considerable cost difference. It is at par with spirit 10% povidone iodine spirit protocol as suggested by FDA in India. There was no reported transfusion associated bacteremia in the study period.
authors.affiliation: Department of Microbiology & Infection Prevention, Kokilaben Dhirubhai Ambani Hospital and Research Institute, Mumbai, Maharashtra, India.
authors.forename: Sweta
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Transfusion Medicine, Kokilaben Dhirubhai Ambani Hospital and Research Institute, Mumbai, Maharashtra, India.
authors.forename: Nidhi Ajay
authors.initials: NA
authors.lastname: Mehta
authors.affiliation: Department of Microbiology & Infection Prevention, Kokilaben Dhirubhai Ambani Hospital and Research Institute, Mumbai, Maharashtra, India.
authors.forename: Sweta Ganesh
authors.initials: SG
authors.lastname: Jadhav
keywords: Bacteremia; blood donor arm; chlorhexidine gluconate