De la détection bactérienne à l'inactivation des pathogènes

[Control of the bacterial risk of transfusion in France in 2013]

Bacterial contamination of blood products (BP) remains the most important infectious risks of blood transfusion in 2013. Platelet concentrates (PC) are the blood products the most at risk, whether CPA or MCPS. In France, the residual risk has been steadily declining since 1994. For the platelets, the frequency of transfusion reaction due to bacterial contamination (TRBC) is now about at one per 50,000 CP distributed. The number of deaths has remained stable since 1994 with one death per year (300,000 distributed CP). The progressive decrease in the number of cases of TRBCs is the result of steady improvement of practices and prevention methods at all stages from collection to the transfusion of BP. But if all these improvements have significantly reduced the incidence of TRBCs, mortality is not changed with the CP and the reduction of this risk is a priority for the French Blood Establishment (EFS). Detection methods of CP contaminated or pathogen inactivation are two approaches available and can provide a significant reduction (for the former) or deletion (for seconds) of the risk of transfused contaminated CP. Currently, the choice is in favor of the detection of bacteria. New detection "rapid tests" methods were added to the panel of candidates and are being evaluated. Inactivation of pathogens remains the safest prospect of eliminating this adverse effect of transfusion. Implementation of one method for bacterial detection is probably a transitional measure.

Les bactéries : je dépiste ou j’inactive ?

The main cause of adverse events secondary to the transfusion of platelet concentrates (PC) is due to bacterial contamination. The detection of bacteria in PC is not associated with a beneficial effect in terms of prevention of fatal septic events. Inactivation of pathogen in PC using photochemical techniques is targeted not only to bacteria but also to a wide spectrum of viruses, spirochetes, parasites and leukocytes. Pathogen inactivation is a pro-active method which anticipates the contamination of the blood pool by emerging pathogens.