Journal List > Ann Clin Microbiol > v.19(1) > 1078546

Shim, Kim, and Hong: Microbial Contamination and Evaluation of Inoculum Volume in Umbilical Cord Blood Culture

Abstract

Background

Microbial screening tests of umbilical cord blood (UCB) are essential for stem cell transplantation. We analyzed the microbial contamination rate and distribution of isolated microorganisms over 10 years of samples from the MEDIPOST Cord Blood Bank. In addition, we studied the influence of inoculum volume microorganism culture and compared the yield and speed of microorganism detection. Methods: Microbial screening tests were performed using a manual method, which includes using an inoculum of 2 mL of plasma, a byproduct of UCB processing from pediatric culture bottles. When positive blood culture was detected, each set was once again inoculated with 2 mL and 4 mL of plasma. Results: From 2004 to 2013, a total of 133,610 UCB units were screened, of which 1,311 (0.9%) tested positive for contamination. The most frequently identified microorganism was Escherichia coli (34.6%), followed by Bacillus spp. (12.8%), Enterococcus faecalis (5.3%) and Klebsiella pneumoniae (4.4%). The total yield rate increased by 0.2% over this time period, although the yield rate of Bacillus spp. increased by 8.3%. Conclusion: The results of this study could be used in many ways with both domestic and international data regarding cord blood contamination. Also, other microbiology laboratories using culture conditions similar to ours could refer this study when preparing guidelines. Finally, by detecting low levels of bacteria, we have contributed to cord blood safety. (Ann Clin Microbiol 2016;19:1–6)

References

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Fig. 1.
Proportion of origin of contaminated microorganism according to 10 years. Abbreviations: GI, gastrointestinal; EN, environment; Un, unidentified.
acm-19-1f1.tif
Table 1.
Microorganism isolated from blood culture positive umbilical cord blood units
Potential contaminant source Frequency (%)
Skin flora 4.71
Coagulase negative staphylococci 1.62
Corynebacterium spp. 1.4
Staphylococcus aureus 0.52
Staphlyococcus spp. 1.03
Propionibactetium acnes 0.07
Micrococcus luteus 0.07
Intestinal flora 59.69
Escherichia coli 34.64
Citrobacter spp. 1.77
Enterobacter spp. 1.18
Enterococcus faecalis 5.31
Enterococcus faecium 2.87
Enterococcus spp. 2.28
Klebsiella pneumoniae 4.42
Klebsiella oxytoca 0.59
Lactobacillus spp. 2.21
Streptococcus agalactiae 2.21
Viridans streptococcus group 0.37
Lactococcus spp. 0.59
Mogarnella morganii 0.07
Pediococcus pentosaceus 0.15
Proteus mirabilis 0.15
Proteus vulgaris 0.07
Serratia marcescens 0.52
Candida albicans 0.29
Environmental contaminants 31.38
Bacillus spp. 12.83
Leuconostoc spp. 0.59
Burkholderia cepacia 3.17
Achromobacter spp. 3.61
Acaligenes spp. 2.8
Stenotrophomonas maltophilia 1.69
Pseudomonas spp. 1.25
Acinetobacter spp. 1.39
Chryseobacterium spp. 0.59
Streptococcus spp. 1.92
Kocuria rosea 0.37
Sphingomonas paucimobilis 0.29
Flavobacterium spp. 0.29
Morganella morganii 0.22
Aeromonas hydrophilia 0.15
Ochrobactrum anthropi 0.15
Elizabethkingia meningoseptica 0.07
Unidentified organism 2.80
Table 2.
Comparison of speed of detection of bacteria from cord blood culture bottles inoculated with 2 and 4 mL of blood
Microorganism Speed of detection 4 mL bottle rather than 2 mL bottle (N) 2 mL bottle only (N) 4 mL bottle only (N) Total (N)
Same day 1 day earlier 2 day earlier 3 day earlier
Escherichia coli 2           2
Bacillus spp. 12 4 1   5 13 (1)* 35
Burkholderia cepacia sp pp. 2           2
Corynebacterium spp.       1     1
Achromobacter xylosoxi dans 1           1
Enterococcus faecalis 1           1
Klebsiella pneumoniae 1           1
Stenotrophomonas malto ophilia 1           1
Streptococcus mitis 1           1
Streptococcus pneumoni ae. 1           1
Streptococcus thoraltens sis         1 (1)* 1
Total (N) 22 4 1 1 5 13 47

* Bacillus spp. and Streptococcus thoraltensis duplicate detection.

Table 3.
Speed of detection of bacteria and Bacillus spp. in accordance with increased inoculum volume before and after
Incubation time Total bacteria Bacillus spp.
Inoculated with Inoculated with Inoculated with Inoculated with
  2 mL bottle (N/%) 4 mL bottle (N/%) 2 mL bottle (N/%) 4 mL bottle (N/%)
1 day 66 (55.93) 69 (52.27) 3 (8.82)  
2 day 14 (11.86) 17 (12.88) 11 (32.35) 12 (24.49)
3 day 15 (12.71) 29 (21.97) 12 (35.29) 26 (53.06)
4 day 9 (7.63) 9 (6.82) 3 (8.82) 8 (16.33)
5 day 5 (4.24) 2 (1.52) 1 (2.94) 1 (2.04)
6 day 6 (5.08) 1 (0.76) 3 (8.82)  
7 day 3 (2.54) 5 (3.79) 1 (2.94) 2 (4.05)
Total (N) 118 132 34 49
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