Efficacy of diversion pouch in prevention of transfusion-transmissible bacterial infections

Abstract

Background and Objectives: Blood transfusion is a lifesaving therapeutic intervention; however, transfusion-transmissible bacterial infections pose a great risk to recipients. Adhering to stringent blood donor disinfection technique in conjunction with first aliquot diversion has mitigated the risks of bacterial sepsis. The aim of this study was to evaluate the prevalence of bacterial contamination and assessing the preventive effect of diversion pouches implemented during whole blood collections in a regional blood center in Rawalpindi, Pakistan. Methods: A cross-sectional study was performed from December 2019 to February 2020. A total of 300 diversion pouches filled with 20 mL of whole blood samples were included in the study. Aerobic and anaerobic blood culture vials were inoculated and incubated in the BD BACTEC™ FX40 instrument at 35°C until positive and for 7 days if negative. The culture vials flagged positive were subcultured onto a set of solid media to isolate and identify the implicated microbial species, followed by testing the whole blood-derived platelet component of the blood sample that tested positive. Results: The prevalence of bacterial contamination of whole blood using the diversion pouch was detected as 0.3% (n = 1/300). The bacterial species identified were coagulase-negative Staphylococcus. The platelet component of the positive whole blood sample showed an absence of the contaminant. Conclusion: The results of this study suggest the significance of diversion as an effective way of preventing bacterial contamination of whole blood components. This necessitates its usage in all other blood banks of Pakistan to enhance the safety of transfused blood.

Keywords

• blood culture
• disinfection
• prevalence