Safety of apheresis platelet transfusions: Analysis of bacterial screening and septic reactions in a South Indian Blood Centre.

BACKGROUND

Bacterial contamination of apheresis platelets (AP) remains a significant challenge in transfusion medicine, especially in low- and middle-income countries. This study evaluates the efficacy of bacterial screening using a negative-to-date (NTD) protocol and investigates the incidence of septic transfusion reactions.

METHODS

A retrospective analysis was conducted over three years at a tertiary care blood center. A total of 1408 AP donations were screened using the BacT/ALERT 3D culture system. Transfusion timelines, culture results, and transfusion reactions were analyzed.

RESULTS

A total of 1408 AP donations were cultured, yielding 2658 units, of which 2637 were transfused. Forty-three donations (3.1 %) flagged positive, but only 12 were confirmed on repeat testing, corresponding to a true positive rate of 0.85 %. Adherence to the NTD protocol was observed in 53.8 % of transfusions, while the remainder were issued earlier. Among 2637 transfused units, 52 transfusion reactions were reported (2.0 %), of which 30 were febrile or suspected septic. Initially, 23 cases raised suspicion for STR; however, following detailed clinical and microbiological review, none met criteria for definite STR, and only 2 cases were categorized as possible STR.

CONCLUSION

Bacterial screening of apheresis platelets using primary culture and a negative-to-date protocol was effectively implemented in our setting, with a 0.85 % true positive rate. Septic transfusion reactions were rare, with no definite cases and only two classified as possible.