Bacteremia in the red blood cells obtained from the cell saver in patients submitted to heart surgery.
Manuel Luque-Oliveros
PMID 32876294WHAT IT FOUND
In 201 heart surgery patients, red blood cells obtained from a cell saver for reinfusion contained bacteria, most often Staphylococcus epidermidis.
The paper does not show these bacteria caused infection or that adding antibiotics to the saver is safe or effective.
Key findings
01The study analysed 201 heart surgery patients whose cell-saver blood was cultured; 157 of 358 scheduled patients were excluded.
02Staphylococcus epidermidis was the most common isolate in the red blood cell bags, reported in 69% (n=138), with Streptococcus sanguinis in 10% (n=20).
03The Staphylococcus epidermidis strain reported resistance to vancomycin, with a minimum inhibitory concentration >16 µg/ml.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is single centre and descriptive, with no comparison group or clinical follow-up, so it cannot show that bacteria in the bag caused infection, sepsis, or other patient harm. It does not determine whether the bacteria represented true bacteremia, contamination from the patient's skin, or contamination during handling of the saver or samples. Patients who were immunosuppressed or receiving antimicrobial therapy were excluded, so the finding may not apply to higher-risk surgical patients. The authors' suggestion to add antibiotics to the cell saver reservoir is not tested in this study, and the common isolate was reported resistant to vancomycin.
The easy way to misread this
Do not read the bacteria found in cell-saver blood as proof that patients became infected or that adding antibiotics to the saver will prevent infection. The study only cultured blood bags; it did not test an intervention or follow clinical outcomes.