Impact of donor arm skin disinfection on the bacterial contamination rate of platelet concentrates

Vox Sang. 2002 Oct;83(3):204-8. doi: 10.1046/j.1423-0410.2002.00219.x.

Abstract

Background and objectives: Despite improved methods for detecting bacterial contamination of blood products, bacterial sepsis remains a significant risk in blood transfusion. This study was undertaken to investigate whether adopting a different skin disinfection protocol could reduce the rate of bacterial contamination of platelet concentrates.

Materials and methods: Two skin disinfection protocols were consecutively used in the routine blood collection setting during two 10-month periods: 0.5% cetrimide/0.05% chlorhexidine solution followed by 70% isopropyl alcohol (first 10-month time-period); and 10% povidone-iodine followed by 70% isopropyl alcohol (second 10-month time-period). The rates of bacterial contamination of platelet concentrates were monitored by using a surveillance programme described previously.

Results: The overall bacterial contamination rate in the first time-period was 0.072%. After introduction of the povidone-iodine and isopropyl alcohol protocol, the bacterial contamination rate decreased to 0.042% (relative risk reduction: -0.42; 95% confidence interval, -0.12 to -0.61, P= 0.009). There were no differences in the types of micro-organisms identified (P = 0.7).

Conclusions: Skin disinfection by povidone-iodine and isopropyl alcohol is more effective than that by cetrimide/chorhexidine and isopropyl alcohol in reducing venepuncture-associated contamination of platelet concentrates by skin flora. Our data indicate that the disinfection protocol should be used on a routine basis and such implementation should translate into a significant improvement in blood safety to patients receiving platelet transfusion.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • 2-Propanol / pharmacology
  • Arm
  • Bacterial Infections / prevention & control
  • Bacterial Infections / transmission*
  • Blood Donors*
  • Blood Platelets / microbiology
  • Blood Specimen Collection
  • Cetrimonium
  • Cetrimonium Compounds / pharmacology
  • Disinfectants / pharmacology
  • Disinfection / methods*
  • Humans
  • Platelet Transfusion / adverse effects*
  • Povidone-Iodine / pharmacology
  • Skin / microbiology

Substances

  • Cetrimonium Compounds
  • Disinfectants
  • Povidone-Iodine
  • 2-Propanol
  • Cetrimonium