Bacterial contamination of blood components – incidence and significance for homologous and autologous transfusion Bakterielle Kontamination von Blutkomponenten – Inzidenz und Signifikanz für die allogene und autologe Transfusion

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Abstract Successful reduction of the risk of viral transmission via blood components has emphasized the risk of transfusion-associated bacterial sepsis. The incidence of transfusion reactions due to bacteria is currently estimated to be between 1:100,000 and 1:1,000,000 units in the case of packed red blood cells and between 1:900 and 1:100,000 units in the case of platelet concentrates. For autologous transfusion, only isolated case reports are available which do not permit a quantitative risk assessment. At present, no reliable data on the risk of morbidity and mortality due to transfusion-associated bacterial infection are available for Germany. Since platelet concentrates, stored at room temperature, provide more favorable conditions for bacterial growth, these blood components are thought to bear a considerably greater risk of bacterial contamination than red blood cells. The rate of contamination of platelet concentrates is cited to be between 0.02 and 1.2%, depending on the production and bacterial culture techniques used, whereas the rate for packed red blood cells is between 0.1 and 0.2%. Risk reduction strategies include careful selection of blood donors, optimization of donation and production techniques, and detection of bacteria in samples of blood components prior to transfusion. Also important for patient safety are quality assurance measures in the preparation for transfusion, patient monitoring, and investigation of transfusion reactions.