MICROBIOLOGIC CONTAMINATION OF PERIPHERAL-BLOOD PROGENITOR CELLS COLLECTED FOR HEMATOPOIETIC-CELL TRANSPLANTATION

Background: Peripheral blood progenitor cells (PBPCs) rather than bone marrow are used increasingly to provide hematologic reconstitution wh en transfused after marrow-ablative chemotherapy. PBPCs often are coll ected via central venous catheters that have remained in place for lon g periods of time and that may become infected. Study Design and Metho ds: The investigators reviewed their 5-year experience in collecting P BPCs for the prevalence of bacterial contamination, Except for cotrimo xazole therapy given to prevent Pneumocystis cariini pneumonia, patien ts were not given antibiotic prophylaxis. Results: Each patient underw ent a median of 7 (range, 2-21) PBPC collections; 0.2 percent (3/1040 collections) were culture positive for bacteria (two collections conta ined coagulase-negative staphylococci and one contained Serratia marce scens). All culture-positive collections were discarded; no PBPCs were culture positive at the time of thawing and transfusion. Conclusion: This contamination rate is below that previously reported for bone mar row harvests and platelet concentrate collections. Obtaining PBPCs thr ough large-bore central venous catheters has not added to the risk of infection in transplant patients. A program of screening in vitro cult ures and strict adherence to sterility techniques can result in very l ow microbiologic contamination and thus obviates the need for prophyla ctic antimicrobials in the PBPCs and in the patient.