A Procedure to Investigate the Efficacy of the Blood Donor Arm Disinfection Procedure for the Prevention of Blood Contamination

Research Article

J Pathol & Microbiol. 2021; 3(1): 1020.

A Procedure to Investigate the Efficacy of the Blood Donor Arm Disinfection Procedure for the Prevention of Blood Contamination

Debrincat A1, Gialanze JP2, Spiteri N2 and Zammit V1,2*

¹Department of Biomedical Science, Faculty of Health Sciences, University of Malta, Malta

²National Blood Transfusion Service, Malta

*Corresponding author: Zammit V, National Blood Transfusion Service, Malta; Email: [email protected] mt

Received: October 18, 2021; Accepted: November 10, 2021; Published: November 17, 2021


The safety of blood products has improved drastically over the years especially when it comes to the detection of viral pathogens. Contamination by bacteria and fungi remains a concern since these lead to transfusion transmitted infections. This project aims to provide a protocol to determine the efficacy of the disinfection procedure used by Blood Establishments. This method is based on collecting swab samples from the antecubital fossa of donors before and after the application of the disinfectant and by culturing of blood collected from the diversion pouch. The colony counts obtained before and after disinfection from the selected Blood Bank were analysed statistically and it was found that the disinfectant regimen currently used was more than sufficient in obtaining the required bacterial reduction and that it eliminated any fungal organisms. From the blood cultures performed, three blood cultures resulted as positive. Upon further investigation using a MALDI-TOF MS based identification technique, the contaminant bacteria were identified. None of these organisms were deemed to have originated because of improper disinfection upon reviewing the identification results obtained from the after-disinfection swabs. This implies that the current disinfection procedure is performing as expected.

Keywords: Bacteria; Fungi; Blood; Sterile; Disinfection


A good disinfection procedure is critical for the prevention of contamination within blood products. Contamination can arise from sources other than the skin of which most notably relate to asymptomatic bacteraemia within donors and the possibility of contaminated equipment used during the collection or processing of blood [1]. In addition to these, contamination may also be due to environmental conditions or the personnel involved not following the established protocols, both internal and external, for the sterile preparation, handling and storage of the desired blood products [2]. The protocol described in this study may help determine whether further actions should be taken to reduce the instances of contamination from the donor. Such actions would include alterations to the formula of the disinfectant such as the increase in the concentration of chlorhexidine, whether a change in the application of said disinfectant protocol is needed and the implementation of wider screening for blood products as well as the use of more advanced blood culture monitoring systems.


This study was ethically approved by the Faculty Research Ethical Committee, Faculty of Health Sciences, University of Malta.

Each Blood Establishment needs to determine its own acceptable bacterial reduction range. This can be done by performing the swabbing exercise described hereunder and averaging the difference between the pre and post disinfection swab counts. However, to be accurate the exercise needs to be performed more than once and on a sample size that captures a good representation of the amount of blood donors.

A summary of the protocol used for this study can be found at Figure 1.