Reduction of Yersinia enterocolitica load in deliberately inoculated blood: the effects of blood prestorage temperature and WBC filtration.

BACKGROUND: Yersinia enterocolitica is known to cause severe infections in patients who receive transfusions. STUDY DESIGN AND METHODS: The aim of the study was to define the best strategy for reducing the bacterial load in blood that was deliberately contaminated with Y. enterocolitica by combining prestorage temperature and WBC filtration with conditions of blood processing close to those applied in blood banks. RESULTS: The effects of three prestorage temperatures (4 degrees C, 20 degrees C, 37 degrees C) were evaluated at various times after infection. The best reduction of bacterial load was achieved after 3 hours at 20 degrees C. In further experiments, conducted according to the former specifications, filtration of whole blood from eight and six donors with an inoculum of 100 and 500 to 1000 CFUs per mL, respectively, resulted in a total inhibition of bacterial growth up to 42 days after infection. After fractionation of blood components, in contrast to plasma and RBCs, filtration was shown to reduce dramatically the bacterial growth in buffy coats, demonstrating that the antibacterial effect of filtration was supported by the removal of infected WBCs from blood samples. CONCLUSION: These results provide support for the systematic use of blood filtration in the preparation of blood components to prevent Y. enterocolitica infection of patients receiving transfusions.

Obtaining cornea donation consent by telephone.

BACKGROUND: Cornea donation process comes up against difficulties in obtaining families' consent. A face-to-face interview is often not possible for logistical reasons. We carried out a prospective study of the effectiveness of telephone contact in obtaining donation consent. METHODS: Consent was obtained by a single, nonmedical, hospital coordinator. If a face-to-face interview was not possible, a telephone interview was conducted using a standardized procedure. RESULTS: Over a 21-month period, 334 families were contacted, either in a face-to-face interview (142, 42.5%) or by telephone (192, 57.5%). Donation consent was obtained in 66.5% of cases, 106 times by telephone and 116 times in face-to-face interview. The acceptance rate was 55.2% by telephone and 81.6% face to face (P<0.001). In total, 47.7% of the cornea recovery consents were obtained after telephone interview. CONCLUSIONS: Telephone interview is an effective method for obtaining consent to cornea donation. Although the acceptance rate using this method is lower than by face-to-face interview, using the telephone should not be overlooked as this enabled procurement of nearly half the corneas in our hospital.