Preventing bacterial infection in blood components

Abstract

BackgroundThe prevention of bacterial infections by blood components can be classified into general procedures and blood component‐specific procedures.General proceduresDonor selection programmes with a temporary deferral of blood donors are sufficient measures to prevent bacterial contaminations of blood components. Secondly, an efficient donor arm disinfection is important to reduce the resident skin flora to a minimum. Since the beginning of this century, all countries have implemented the predonation sampling with the diversion of the first 30–40 ml.Blood components specific proceduresMany countries have already implemented methods of detecting bacteria in platelets using culture methods. A residual risk for culture methods, however, is the occurrence of sample errors by collecting the test volume within the first 24 h. Some countries have implemented rapid bacterial detection systems like Bactiflow or NAT systems. Different pathogen reduction methods were developed for platelets, plasma and packed red cells. The advantage of these methods is the reduction of all bacteria and potential new pathogens. A disadvantage might be their high cost and limited efficiency in detecting bacteria spores.ConclusionGeneral procedures are not sufficient to prevent all bacterial transmissions. Culture methods and pathogen reduction methods that have focused on the prevention of bacterial contamination in platelets are currently in development for erythrocytes and whole‐blood components and might not be feasible for stem cell components. Therefore, the world is still waiting for a new general procedure that will be an addendum to existing systems – such a system is eagerly awaited.