Oct. 18, 2001 CLEVELAND --(October 16, 2001)-- Doctors at University Hospitals of Cleveland released the results of an investigation of a new method to detect bacterial contamination in blood platelets at the annual meeting of the American Association of Blood Banks today. They found that the Pall BDS, a new detection device, was able to detect all bacteria in platelets that were studied.
Roslyn Yomtovian, MD, director of University Hospitals’ Blood Bank and Transfusion Medicine Service and lead investigator, says that bacteria are the most common infectious agents transmitted by blood, and present a far greater threat to public health than viruses such as HIV and hepatitis. The transfusion risk for acquiring such viruses has greatly diminished due to improvements in blood donor screening.
“With 9 million platelet units and 12 million red blood cell units transfused in the United States every year, at least 3,000 transfusions, primarily platelets, are contaminated with bacteria and cause severe illness or death for hundreds of patients across the country,” Dr. Yomtovian says. Platelets are particularly vulnerable to bacterial contamination because they must be stored at room temperature, which facilitates bacterial growth, she says.
Dr. Yomtovian, and pathologists Michael R. Jacobs, MD, and Elizabeth Palavecino, MD, studied the Pall BDS. The system measures oxygen in a sample obtained from a platelet unit. Because bacteria consume oxygen, abnormally low levels of oxygen in the platelet sample indicate the presence of bacteria, resulting in contaminated platelets being detected and discarded.
The investigators evaluated bacterial species that represent nearly all of the deaths resulting from bacterially contaminated platelets. In those cases, the Pall BDS detected bacterial contamination of the platelets. No false positive results were reported.
“Bacteria can be present in platelets in very low number and different strains can multiply at different rates, thereby making detection difficult,” Dr. Jacobs says. “That is why this method holds so much promise. If blood banks have the technology to detect bacteria before platelets are used for transfusion, it follows that fewer patients will receive contaminated blood and develop an illness.”
Transfused platelets can be contaminated from a variety of sources including the donor’s own blood and the equipment used. The contamination most often occurs during the collection process. Dr. Yomtovian says that bacteria present on the skin of most healthy people may enter the blood during the donation process. No matter how much disinfectant is applied to the skin, it cannot be completely sterilized and some bacteria remain.
In an editorial for the November 2001 issue of the journal, Transfusion, Drs. Jacobs, Palavecino and Yomtovian issue a call for action to make blood products safer.
“In an era in which the risk of transmission of recognized transfusion-transmitted viruses, particularly HIV, has been virtually eliminated, it is paradoxical and somewhat ironic that the earliest recognized infectious transfusion complication, bacterial contamination, is now the most frequent and is proving the most difficult to eradicate,” the authors write.
The Research Institute at University Hospitals of Cleveland supported the study.
University Hospitals Health System is the region's premier health care delivery system, serving patients at more than 100 locations in 40 Northern Ohio communities. Included is a network of physicians, outpatient centers and hospitals; wellness programs, occupational health, skilled nursing, elder health, rehabilitation services and home care; and managed care and insurance.
The System includes: the region's largest network of primary care physicians; the region's largest number of ambulatory care centers; Rainbow Babies & Children's Hospital, one of the world's renowned pediatric hospitals; Ireland Cancer Center, Northern Ohio's only National Cancer Institute-designated cancer center; MacDonald Women's Hospital, Ohio's only hospital for women; and Laurelwood Hospital, the region's leading provider of mental and behavioral health services.
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