Recommendations of Clark et al to Avoid and Detect Microbial Contamination of Cord Blood Collected for Stem Cell Transplant

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Clark et al identified a number of factors that may contribute to microbial contamination of cord blood and that may affect whether contaminants are detected or not. This can be important to ensure safety of patients receiving stem cells from the cord blood.

Many different types of organisms (aerobic bacteria, anaerobic bacteria, yeast, fungi) can contaminate cord blood and testing should be able to detect all of them.

Factor Influencing Contamination	Lower Risk	Higher Risk
method of delivery	Cesarean section	vaginal delivery
person who collects	trained and experienced	untrained staff
cleaning umbilical cord	effective antiseptic (chlorhexidine, other)	no or ineffective antiseptic
processing	closed system	not closed system

Factor Influencing Detection	More Effective	Less Effective
testing	aerobic and anaerobic bacteria, fungi	aerobic bacteria only
testing volume	high	minimal (pediatric blood culture bottle)
incubation	5+ days	one or two days

The higher the volume of product tested the greater the likelihood of detecting a contaminant present in low numbers. The authors recommended testing both the discard fraction and the final product.

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Recommendations of Clark et al to Avoid and Detect Microbial Contamination of Cord Blood Collected for Stem Cell Transplant

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