Analysis of bacterial detection in whole blood-derived platelets by quantitative glucose testing at a university medical center

Am J Clin Pathol. 2009 Apr;131(4):542-51. doi: 10.1309/AJCPVN9OT4GRCSKO.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Academic Medical Centers
  • Adult
  • Bacterial Infections / etiology*
  • Blood Platelets / microbiology*
  • Glucose / analysis*
  • Humans
  • Middle Aged
  • Platelet Transfusion / adverse effects*
  • Quality Assurance, Health Care*

Substances

  • Glucose