The prevalence of Methicillin-resistant Staphylococcus aureus in blood product hampers at the South African National Blood Service.

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA), are strains of the Gram-positive cocci known to cause various health conditions. Patients suffer from abscesses, skin infections and more severe conditions such as osteomyelitis and septicaemia. These bacteria are highly resistant to antibiotics and bacteria such as these are a great risk to the public, especially since Staphylococcus aureus is an opportunistic bacterium. In 2016, a donor unit received for the production of eye serum at South African National Blood Service (SANBS), when quality controlled, tested positive for MRSA. The bacterial contamination was traced to a staff member at the clinic where the blood was donated. Little research has been conducted to determine if MRSA is a problem and if it could negatively affect the blood supply. Aim: The aim of this study was to determine whether blood services contribute to the spread of MRSA and other bacterial pathogens through the blood product hamper system. Materials and Methods: A cross-sectional study to determine the prevalence of MRSA on 850 blood product hampers moving between SANBS inventory laboratories and blood banks, was conducted at SANBS between August 2020 and May 2021. Hampers were swabbed with a Sigma-Transwab containing liquid Amies transport medium for the detection of MRSA. The swabs were cultured onto CHROMagar MRSA where a rose or mauve coloured colony confirmed the presence of MRSA. Bacterial contaminants which were detected during the testing procedure were isolated, and loaded onto the Vitek 2 Compact for bacterial identification. Results: A total of 696 hampers were processed as per the study protocol (81.9%). Out of the 850 hampers planned to be swabbed, 143 (16.8%) hampers were not swabbed as a result of staff not performing the procedure and swabs from 11 hampers were omitted (1.3%) as they did not comply too protocol requirements. Of the 696 hampers swabbed, MRSA was not detected (0%) however, bacterial growth other than MRSA was observed. The most common isolates detected were Aerococcus viridans, Rothia dentocariosa, followed by Bacillis spp as well as Stenotrophomonas maltophilia. Conclusion: The study findings have shown that an effective hamper cleaning system is needed to safeguard the integrity of our blood supply. The findings of this study should be taken into consideration throughout all provinces at SANBS, for the consistent and regular cleaning of hampers, which carry blood and blood products.