Sandra Ramirez-Arcos^1,2, Jin Ye Yeo³

¹Innovation and Portfolio Management, Canadian Blood Services, Ottawa, Ontario, Canada; ²Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada; ³AOB Editorial Office, AME Publishing Company

Correspondence to: Jin Ye Yeo. AOB Editorial Office, AME Publishing Company. Email: aob@amegroups.com

Expert introduction

Dr. Sandra Ramirez-Arcos (Figure 1) is a Senior Scientist at Canadian Blood Services and an Adjunct Professor at the University of Ottawa in Ottawa, Canada. She completed her bachelor and master’s degree in microbiology in her native Colombia, and her PhD studies in biological sciences in Spain. From 1998 to 2002, she did her post-doctoral training and worked as a research associate at the University of Ottawa, Canada. In 2003, she joined Canadian Blood Services and obtained her adjunct professorship at the University of Ottawa. Dr. Ramirez-Arcos has built a strong team with expertise on bloodborne bacteria with focus on understanding bacterial growth dynamics, with interests in biofilm formation and molecular modulation during blood component storage. Her laboratory oversees the development, validation and implementation of protocols and processes aiming at enhancing blood component safety.

Figure 1 Dr. Sandra Ramirez-Arcos

Interview

AOB: Could you share what inspired you to dedicate your research to bloodborne bacteria, particularly in the areas of bacterial contamination in blood components, biofilm formation, and bacteria growth in blood products?

Dr. Ramirez-Arcos: As a trained microbiologist, with expertise in bacteriology, I had a great opportunity when I joined Canadian Blood Services over 20 years ago to apply my knowledge and skills set to investigate bloodborne bacteria. I was especially inspired by the possibility of generating evidence-based data to enhance the safety of transfusion patients.

AOB: Could you provide a brief overview of the current publication landscape in the detection of bacterial contamination in platelets? Are there any findings that stood out to you?

Dr. Ramirez-Arcos: Screening of blood components, in special platelet concentrates, for bacterial contamination has advanced in recent years with automated culture systems and rapid test methods. Although these techniques have been proven to enhance the safety of platelet concentrates, there are still reports of septic transfusion reactions involving contaminated platelet units that were missed during screening. Therefore, there is always an opportunity to improve the detection systems or work with algorithms combining different approaches to maximize detection of contaminated blood products.

AOB: In an international survey conducted by the bacterial subgroup of ISBT Transfusion-Transmitted Infectious Diseases Working Party, findings highlighted the lack of consensus in microbiological environmental monitoring among transfusion services (1). What are some challenges that need to be overcome to bring out this consensus guideline?

Dr. Ramirez-Arcos: The lack of consensus in microbiological monitoring poses a challenge when assessing and comparing safety risks and mitigation strategies at different organizations. Production teams should work together with Quality Assurance to implement the best practices available in each jurisdiction.

AOB: In your opinion, what are some strategies to overcome these challenges and help facilitate the adoption of environmental monitoring?

Dr. Ramirez-Arcos: It is important that each blood production center carefully evaluates and validates methods to minimize the risk of contaminating blood components during production, storage, and transportation. Applying Good Manufacturing Practices is paramount to issue safe blood components for transfusion.

AOB: Could you share some of the significant protocols and processes to detect and reduce bacterial contamination in blood that your team at Canadian Blood Services has implemented? How have these implementations enhanced blood component safety?

Dr. Ramirez-Arcos: We have implemented all the mitigation strategies known to improve the safety of blood components, including a stringent blood donor interview prior to donation, optimal skin disinfection, diversion of the first aliquot of donated blood, platelet component screening for bacterial contamination, and more recently, platelet component treatment with a pathogen reduction technology. We have evidence that our changes have enhanced blood component safety; one example was the modification of our platelet testing algorithm that resulted in detection (and interdiction) of more contaminated platelet units (2).

AOB: Moving forward, what are some goals that your team hope to achieve in the next few years?

Dr. Ramirez-Arcos: We will continue working towards improving blood components safety. Our focus will be on novel processes and testing methods aimed at detecting or inactivating current and emergent bloodborne pathogens.

AOB: As an Editorial Board Member, what are your expectations for AOB?

Dr. Ramirez-Arcos: To improve dissemination of articles relevant to transfusion-transmitted infections and emergent pathogens.

Reference

1. Ramirez-Arcos S, Garcia-Otalora M, McDonald C; ISBT Transfusion-Transmitted Infectious Diseases Working Party, Subgroup on Bacteria. Microbiological environmental contamination in the blood supply chain: An international survey by the bacterial subgroup of the ISBT Transfusion-Transmitted Infectious Diseases Working Party. Vox Sang. 2023;118(8):656-665.
2. Ramirez-Arcos S, Evans S, McIntyre T, et al. Extension of platelet shelf life with an improved bacterial testing algorithm. Transfusion. 2020;60(12):2918-2928.