Preliminary determination of bacterial contamination of whole blood units in a Ghanaian blood bank: Providing evidence to improve transfusion safety

Abstract

BACKGROUND AND OBJECTIVES: Transfusion-associated bacterial sepsis poses a significant risk to patient safety. This study aimed to determine the rate of bacterial contamination of whole blood (WB) collected at the Cape Coast Teaching Hospital (CCTH) as a quality control and quality assurance activity. MATERIALS AND METHODS: One-hundred and three WB units collected between January and April of 2018 were screened for bacterial contamination. Bacteria isolated from positive cultures were identified and subjected to antimicrobial testing. WB recipients were followed up for clinical symptoms. RESULTS: Of the 103 WB units tested, 33 (32%) were contaminated with bacteria. Gram-positive organisms accounted for 67% of the isolates, including coagulase-negative Staphylococcus, Staphylococcus aureus and Bacillus spp., while Gram-negative bacteria comprised 33% of the isolates, with Citrobacter freundii, Serratia marcescens, Escherichia coli and Providencia stuartii being identified. Resistance to antibiotics varied between species. No septic transfusion events were reported involving WB units tested in this study. CONCLUSION: The high percentage of contaminated WB units collected at the CCTH provided evidence-based data for the implementation of improved donor skin disinfection processes and the use of blood diversion pouches in 2019. These approaches allowed CCTH to comply with Ghanaian regulatory entities.