| Sumario: | Since the impressive reduction of transfusion-transmitted virus infections, bacterial infections by blood transfusion represent the most important infection risk. In the current focus of attention are platelet concentrates as they are stored under temperature conditions which allow the growth of contaminating bacteria up to 1010 and more microbes per platelet bag. This paper does not consider the pathogen inactivation methods but will assess suitable screening methods. Beside conventional microbiological approaches or surrogate markers, several efficient methods able to detect bacterial contamination in platelets are available on the market. They have to be divided into two different methodological principles: The incubation methods and the rapid methods. Incubation or cultivation methods require some time for signal production as they depend on the growth of microbes. Thus, they have to be combined with early sampling, i.e., the sample to be examined has to be drawn from the blood component one day after donation. Their advantage is the relatively uncomplicated implementation into the logistics of blood banks. Because of the initially very low count of bacteria after donation a certain small sampling error remains in the application of that strategy. Rapid methods are able to produce the diagnosis within a short time. Therefore, they allow postponing of sample drawing, ideally up to the time immediately before transfusion. However, that procedure causes logistical complications. On the other hand, late sampling combined with a rapid method will prevent the transfusion of highly contaminated platelet concentrates leading to acute septic shock and even death of the patient. Considering the sum of different aspects, the potential improvement of microbial safety of platelet concentrates is comparable in both strategies.
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