Dataset Information

Bacterial contamination of blood products for transfusion in the Democratic Republic of the Congo: temperature monitoring, qualitative and semi-quantitative culture.

ABSTRACT:

Background

Bacterial contamination of blood for transfusion is rarely investigated in low-income countries. We determined the contamination rate of blood products in the Democratic Republic of the Congo.

Material and methods

In this prospective observational study, blood products in one rural and two urban hospitals (paediatric and general) contained a satellite sampling bag by which blood was sampled for culture in a blood culture bottle (4 mL) and on an agar-coated slide to estimate colony forming units (CFU/mL). Bacteria were identified with biochemical tests and MALDI-TOF (Bruker). Exposure time >10 °C was assessed on a subset of blood products.

Results

In total, 1.4% (41 of 2,959) of blood products were contaminated with 48 bacterial isolates. Skin (e.g., Staphylococcus spp.) and environmental (e.g., Bacillus spp.) bacteria predominated (97.8% of 45 isolates identified). Bacterial counts were ≤10³ CFU/mL. Contamination rates for the urban paediatric, urban general and rural hospitals were 1.6%, 2.4% and 0.3%, respectively (p=0.004). None of the following variables was significantly associated with contamination: (i) donor type (voluntary 1.6%, family 1.2%, paid 3.9%); (ii) type of blood product (red cells 1.6%, whole blood 0.6%); (ii) season (dry season 2.4%, rainy season 1.8%); (iv) age of blood product (contaminated 8 days vs non-contaminated 6 days); and (v) exposure time >10 °C (median for contaminated and non-contaminated blood reached maximum test limit of 8 hours).

Discussion

A bacterial contamination rate of 1.4% of whole blood and red cells is similar to results from high-income countries. Implementation of feasible risk-mitigation measures is needed.

SUBMITTER: Heroes AS

PROVIDER: S-EPMC7592166 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Bacterial contamination of blood products for transfusion in the Democratic Republic of the Congo: temperature monitoring, qualitative and semi-quantitative culture.

Heroes Anne-Sophie AS Ndalingosu Natacha N Kalema Jocelyne J Luyindula Aimée A Kashitu Dorothée D Akele Catherine C Kabinda Jeff J Lagrou Katrien K Vandekerckhove Philippe P Jacobs Jan J Lunguya Octavie O

Blood transfusion = Trasfusione del sangue 20200806 5

<h4>Background</h4>Bacterial contamination of blood for transfusion is rarely investigated in low-income countries. We determined the contamination rate of blood products in the Democratic Republic of the Congo.<h4>Material and methods</h4>In this prospective observational study, blood products in one rural and two urban hospitals (paediatric and general) contained a satellite sampling bag by which blood was sampled for culture in a blood culture bottle (4 mL) and on an agar-coated slide to esti ...[more]

PMID: 32931413

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Project description:BackgroundAs part of the containment of the COVID-19 pandemic, mobile handwashing stations (mHWS) were deployed in healthcare facilities in low-resource settings. We assessed mHWS in hospitals in the Democratic Republic of the Congo for contamination with Gram-negative bacteria.MethodsWater and soap samples of in-use mHWS in hospitals in Kinshasa and Lubumbashi were quantitatively cultured for Gram-negative bacteria which were tested for antibiotic susceptibility. Meropenem resistant isolates were assessed for carbapenemase enzymes using inhibitor-based disk and immunochromatographic tests. Mobile handwashing stations that grew Gram-negative bacteria at counts > 10,000 colony forming units/ml from water or soap were defined as highly contaminated.ResultsIn 26 hospitals, 281 mHWS were sampled; 92.5% had the "bucket with hand-operated tap" design, 50.5% had soap available. Overall, 70.5% of mHWS grew Gram-negative bacteria; 35.2% (in 21/26 hospitals) were highly contaminated. Isolates from water samples (n = 420) comprised 50.3% Enterobacterales (Klebsiella spp., Citrobacter freundii, Enterobacter cloacae), 14.8% Pseudomonas aeruginosa and 35.0% other non-fermentative Gram-negative bacteria (NFGNB, including Chromobacterium violaceum and Acinetobacter baumannii). Isolates from soap samples (n = 56) comprised Enterobacterales (67.9%, including Pluralibacter gergoviae (n = 13)); P. aeruginosa (n = 12) and other NFGNB (n = 6). Nearly one-third (31.2%, 73/234) of Enterobacterales (water and soap isolates combined) were multi-drug resistant; 13 isolates (5.5%) were meropenem-resistant including 10 New Delhi metallo-beta-lactamase (NDM) producers. Among P. aeruginosa and the other NFGNB, 7/198 (3.5%) isolates were meropenem resistant, 2 were NDM producers. Bacteria listed as critical or high priority on the World Health Organization Bacterial Priority Pathogens List accounted for 20.3% of isolates and were present in 12.0% of all mHWS across 13/26 hospitals. Half (50.5%) of highly contaminated mHWS were used by healthcare workers and patients as well as by caretakers and visitors.ConclusionsMore than one third of in-use mobile handwash stations in healthcare facilities in a low resource setting were highly contaminated with clinically relevant bacteria, part of which were multidrug resistant. The findings urge a rethink of the place of mobile handwash stations in healthcare facilities and to consider measures to prevent their contamination.

Dataset Information

Bacterial contamination of blood products for transfusion in the Democratic Republic of the Congo: temperature monitoring, qualitative and semi-quantitative culture.

Background

Material and methods

Results

Discussion

Publications

Bacterial contamination of blood products for transfusion in the Democratic Republic of the Congo: temperature monitoring, qualitative and semi-quantitative culture.

Similar Datasets

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