A positive culture from a blood product may be due to contamination during the collection, handling or processing. Identification of the cause is important to prevent further wastage of donated products.


Features suggesting some form of contamination:

(1) evaluation of donor shows no sign of overt or occult infection

(2) bacterial culture isolates a skin contaminant (coagulase negative Staphylococcus, alpha hemolytic Streptococcus, diphtheroid or Propionobacteria)

(3) one or more sources of contamination identified on process review

(4) reculture of the donor product is negative (suggests contamination of the sample used for culture)


Possible sources of contamination:

(1) arm preparation and venipuncture

(2) blood product collection

(3) blood product handling and processing

(4) phlebotomist or technologist error

(5) supply problem

(6) misidentification


Arm preparation and venipuncture:

(1) use of a suboptimal or nonvalidated method of skin preparation

(2) failure to adequately clean the skin (improper technique, not waiting for components to dry, skipping steps)

(3) contamination of the site after preparation (repalpation of the vessel, other)

(4) skin lesion at the venipuncture site making cleaning difficult

(5) difficulty with the venipuncture

(6) excessive manipulation of the needle during the collection


Blood product collection:

(1) use of a nonsterile collection kit

(2) failure to use a diversion pouch at the beginning of the collection

(3) difficulties encountered during the collection


Blood product handling and processing:

(1) improper cleaning of access port prior to entry

(2) failure to use sterile technique in entering the product

(3) use of a nonsterile connection device

(4) deviation from standard protocol during product handling or processing


Technologist error:

(1) new phlebotomist or technologist with incomplete orientation and training

(2) involved in a previous episode of product contamination

(3) directly observed error in collection or handling


Supply problem:

(1) positive culture from a supposedly sterile device

(2) more than one donor product with evidence of contamination

(3) manufacturer recall



(1) misidentification of donor unit or donor sample

(2) misidentification of the product culture


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