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The things we do for safety – Battling bacteria (part II)

Thursday, June 8, 2017 Dr. Sophie Chargé
Categories: Blood, Transfusion, Safety

Previous posts in our "The things we do for safety" series

In a previous post, we wrote about the donor screening criteria, the arm scrub and the diversion pouch. These are important steps in our blood collection process to limit the introduction of bacteria present on the skin or in the blood of donors into blood products. In this post, we explore other lines of defence in our battle against bacteria.

The entire blood product manufacturing process is conducted in a “closed-system”. Through a clever set-up of tubings and bags, the collected blood is never exposed to the external environment (containing millions of bacteria) during the production process. That is why the industry has developed the intricate collection bag that you will see when you come to our clinics to donate. We have come a long way from the glass collection bottles that were used in the early days of transfusion medicine. Our extensive quality system ensures that our products are regularly tested for bacterial contamination.

                      Blood transfusion bottle, capped, with associated parts, Eng Wellcome L0066184   modern-day collection bags

But even with all of these lines of defence, there is still risk that the blood product could be contaminated. So a visual check is performed on all blood products. While a single bacterium is invisible to the human eye, when they grow to large numbers they sometimes leave traces of their presence that are unmistakable to a trained specialist.

Staff in our organization and at hospitals are trained to do this visual inspection before blood components are shipped to hospitals and transfused. The most common signs would be an increased opacity of the product (bacteria in large numbers), the presence of excessive and unusual air bubbles (bacteria may produce gas), and presence of clots and fibrin strands (bacteria may activate the clotting process). We publish a Visual Assessment Guide to educate professionals on what to look for. Products showing those visual signs are not acceptable for transfusion and are discarded.

                   Visual Assessment Guide cover  visual check of platelet unit

For platelet products we go one step-further. You may recall from our earlier blog about Platelets that this product must be stored at room temperature and in plasma, this makes for a particularly good environment for bacteria to grow. In 2004, Canadian Blood Services implemented the routine testing of all platelet units.

BacT/alert culture bottles

For every platelet product, we remove 8-10 mL which we add to a BacT/ALERT culture bottle — an environment that promotes bacteria growth if bacteria is present — and we monitor for bacteria growth over a few days. If bacteria is detected, then the platelet unit is discarded or recalled from the hospital. If additional products were made from the blood donation then those products are also recalled and discarded.

 

Dr. Sandra Ramirez, a development scientist at Canadian Blood Services’ Center for Innovation in Ottawa, is our in-house microbiology expert. She is working on a number of projects focused on bacteria and improving the safety and quality of blood products. 

Further reading:

Don't miss our two previous posts in "The things we do for safety" series which explored the first lines of defence in battling bacteria — donor screening criteria, the arm scrub and the diversion pouch — and leukoreduction — how white blood cells or leukocytes get filtered out of blood products to reduce the risk of transfusion-related reactions.

 


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The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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About the author

Dr. Sophie Chargé

Dr. Sophie Chargé

Dr. Sophie Chargé is the associate director of knowledge mobilization with Canadian Blood Services’ Centre for Innovation. Sophie trained as a medical lab technologist in France, went on to pursue a PhD in developmental biology from the University of London and post-doctoral training in cellular and molecular biology at the Ottawa Hospital Research Institute. Her research training took her from studying type 2 diabetes to skeletal muscle development and regeneration. Sophie left the “bench” to pursue her interests in developing programs that facilitate knowledge mobilization and dissemination to further the impact of research and promote evidence-based decision-making.

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