RESUMO
BACKGROUND AND OBJECTIVES: Bacterial infection through contaminated blood is currently the greatest infection risk in relation to a transfusion. Deferral of prospective blood donors with a skin disorder is a common practise, because bacteria usually originate from the donor's skin. The effectiveness of current deferral guidelines to prevent the bacterial contamination of blood has not been assessed. MATERIALS AND METHODS: We recruited 55 blood donors with a skin disorder that prevented donation, and matched three controls for each case. The donors filled out a questionnaire and one bacterial culture sample was taken from venepuncture forearm skin. RESULTS: The median total number of colony forming skin bacteria was significantly higher in the cases (224 CFUs per sample) than controls (105 CFU per sample). Staphylococcus aureus was significantly more often present on the skin in cases (49%) as compared to controls (7%). Regarding other bacterial genera, no difference between cases and controls was found. CONCLUSIONS: This study shows that our current guidelines for deferral of blood donors with skin disorders effectively identifies individuals with a high number of bacteria on their skin, as well as S. aureus carriers. However, deferral due to skin disorders had only a minor impact on blood product contamination when compared to other actions.
Assuntos
Transfusão de Componentes Sanguíneos , Doadores de Sangue , Seleção do Doador/métodos , Pele/microbiologia , Infecções Cutâneas Estafilocócicas/microbiologia , Staphylococcus aureus , Estudos de Coortes , Humanos , Masculino , Infecções Cutâneas Estafilocócicas/transmissãoAssuntos
Doadores de Sangue , Programas de Rastreamento/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Viroses/diagnóstico , HIV-1/genética , Hepacivirus/genética , Humanos , Cooperação Internacional , Programas de Rastreamento/normas , Programas de Rastreamento/tendências , Técnicas de Amplificação de Ácido Nucleico/estatística & dados numéricos , RNA Viral/sangue , Sensibilidade e Especificidade , Reação Transfusional , Viroses/transmissãoRESUMO
This population-based, retrospective, cohort study describes a large methicillin-resistant Staphylococcus aureus (MRSA) epidemic caused by one strain (E1) in the greater Helsinki region. The epidemic comprised 210 cases at several hospitals, but was finally controlled. The study period ranged from June 1991 to December 2000. The epidemic peaked in 1993-1995 with 143 cases (68% of total cases). From August 1993, all MRSA-positive cases at the eight municipal hospitals were isolated and barrier nursed. Contacts were cohorted and screened for MRSA colonization. Decolonization treatment was administered to some chronic carriers. MRSA cases and contacts were identified in the joint patient register of the municipal hospitals from August 1993. The annual incidence of MRSA E1 in Helsinki City area per 100,000 inhabitants rose from 0.2 in 1991 to 13.6 in 1994. It decreased from 1995, reaching 0.7 per 100,000 in 2000. A jointly agreed policy on MRSA and timely co-operation between all units were essential for control of this epidemic.
