Summary of the AABB interorganizational task force on bacterial contamination of platelets: Fall 2004 impact survey

BACKGROUND: New voluntary standards in the United States regarding bacterial contamination of platelets (PLTs) led to the formation of the AABB Interorganizational Task Force on Bacterial Contamination of Platelets. This article summarizes a survey conducted by the Task Force to assess the impact of bacterial detection. STUDY DESIGN AND METHODS: An Internet-based survey of AABB member institutions was conducted from September 17, 2004, to October 1, 2004. The survey was designed principally to assess PLT usage, supply, and outdating and the currently used bacteria detection methods. RESULTS: Of 900 facilities surveyed, 350 responded (38%). These facilities collected approximately 43.3 and 65.9 percent and transfused approximately 19.1 and 22.2 percent of the whole blood-derived PLT concentrates (WBPCs) and apheresis PLTs in the United States, respectively. Most facilities (64-91%) indicated that their ability to provide PLTs for transfusion had not been affected. Approximately half (50-57.1%) indicated no changes in their PLT inventory. Two-thirds (66-68%) indicated no increased PLT outdating. More than 90 percent of apheresis PLTs are tested with a culture-based method, whereas WBPCs are tested with a variety of methods (mostly non-culture-based) resulting in a 4.6-fold decrease in the confirmed positive detection rate compared with apheresis PLTs (p < 0.001). CONCLUSION: After the implementation of AABB Standard 5.1.5.1, the majority of facilities responding to this survey experienced no (or modest) impact on PLT availability or outdating. Nevertheless, a substantial portion of facilities experienced both increased outdating and decreased availability. Some facilities were greatly impacted. Based on the data gathered, it is impossible to conclude whether such shortages resulted from production or distribution problems or were due to decreased shelf life and increased outdates.