Bacterial Contamination of at-Point-of Transfusion Blood in a Tertiary Hospital in Ghana

Abstract

Background: Hand-in-hand demand for blood transfusion and transfusion-related bacterial infections among blood recipients in Sub-Saharan Africa have increased. Due to resource constraints and increased demand for blood donations in Sub-Saharan Africa, it is a common practice at some blood transfusion centers, where after initial screening of blood and its storage, the stored blood (non- expired blood) is not rescreened at least for bacterial contamination prior to transfusion, a practice which has the potential to expose blood recipients to high risk of bacterial sepsis, especially if blood were donated at window period of contaminating pathogens. This study investigated bacterial contamination of whole blood at-point-of-transfusion at a referral hospital in the western region of Ghana. Method: Pre-screened and stored blood units about to be sent out for transfusion to recipients at patient wards were purposively sampled, and cultured in different culture media (brain heart infusion broth, blood agar, Mackonkey agar, and plate count agar). Colo- nial morphology, Gram stain reactivity, and standard biochemical and bacteriological methods were used to identify bacteria isolates. Standard plate count was used to enumerate growth of each bacteria isolate. Results: From 97 blood units sampled, 16 (16.5 %) were blood contaminated (30-300 cfu/ml) with Gram-negative (E. coli, Pseu- domonas aeruginosa, and Enterobactersp) and Gram-positive (Bacillus sp, Staphylococcus aureus, and Staphylococcus epidermidis) bacteria species. A total of 16 bacteria isolates comprising Gram-negative (43.8 %) and Gram-positive (56.2 %) were identified. Conclusion: Bacterial contamination of at-point-of-transfusion may be common in the study area, and while this observation may stimulate further investigations, local hospital-constituted transfusion oversight committees as well as national, regional, and district health authorities must increase monitoring, supervision, and enforcement of standard sterile and aseptic procedures at all blood transfusion centers nation wide.