International forum on management of blood donors with culture-positive platelet donations : summary

Bacterial contamination of platelets (Plts) stored at room temperature represents the highest risk for infection and fatality of any transfusable blood component. Contamination mitigation procedures include optimization of arm disinfection, sample diversion of initially collected blood, shorter dating or pathogen inactivation to avoid or prevent log-phase bacterial growth as well as detection of bacteria through immunoassay for bacterial antigens, assays for bacterial metabolic activity or bacterial culture. Point-of-care assays are operationally challenging for transfusion services, which often prefer that the blood collection establishments (BCEs) employ enhanced culture strategies or provide pathogen-reduced Plt products. The aim of this International Forum was to understand not only how Plt bacterial culture strategies are being employed by blood collectors internationally but, more specifically, how culture results impact donor management and ongoing donation eligibility. Using a proposed consensus definition of bottle and unit culture results following an automated sample incubator alarm, we desired to catalogue BCE procedures and donor work-ups as well as evaluation strategies for various scenarios, ranging from machine false-positive alarms to potentially bacteremic blood donors.