{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:48:26Z","timestamp":1782456506265,"version":"3.54.5"},"reference-count":12,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:p>Antiseptic barrier caps are currently used as novel tools in critically ill patients to achieve sterility of the blood sampling site and to prevent central line-associated bloodstream infections in the intensive care unit. A clinical and laboratory case of analytical interferences on erythrocytes, platelets and leukocytes due to the isopropyl alcohol contained in the antiseptic barrier cap is described. An aged man with history of heart valve disease was monitored for hematological parameters after surgery of mitral and tricuspid valve replacement. Leukocyte scattergrams changes on the Sysmex XN 2000 analyzer with the suspicion of platelet clumps were observed. After investigation on sampling procedure, antiseptic barrier cap of an arterial access (BD PureHub disinfecting cap) was used. Another sample has been requested, and the analysis of complete blood count and peripheral blood smear confirmed the presence of clumped microerythrocytes and erythrocytes with damaged membranes. In addition, differential leukocyte count revealed an overestimation of eosinophils by 10%. A new sample taken from venous access provided accurate results without alterations. The preanalytical error generated during blood sampling highlights the importance of correct use of biomedical devices. Furthermore, hematology analyzer technology represents a promising tool for assessing sample quality.<\/jats:p>","DOI":"10.11613\/bm.2026.021001","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T07:48:58Z","timestamp":1781164138000},"page":"369-374","source":"Crossref","is-referenced-by-count":0,"title":["A challenging laboratory case due to inappropriate sampling through an antiseptic barrier cap"],"prefix":"10.11613","volume":"36","author":[{"given":"Fabio","family":"Bottari","sequence":"first","affiliation":[{"name":"Clinical Laboratory Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Frisoli","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Mandelli","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Piras","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Introcaso","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"key20260611074853_r1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.ajic.2022.09.005","article-title":"Antiseptic barrier caps to prevent central line-associated bloodstream infections: A systematic review and meta-analysis.","volume":"51","author":"Gillis","year":"2023","journal-title":"Am J Infect Control"},{"key":"key20260611074853_r2","unstructured":"Guidelines for the Prevention of Intravascular Catheter-Related Infections. 2011. Available from: https:\/\/www.cdc.gov\/infection-control\/hcp\/intravascular-catheter-related-infection\/index.html Accessed January 15th 2026."},{"key":"key20260611074853_r3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.21037\/jlpm-23-32","article-title":"Modern hematology analyzers: beyond the simple blood cells count (with focus on the red blood cells).","volume":"9","author":"Daves","year":"2024","journal-title":"J Lab Precis Med"},{"key":"key20260611074853_r4","doi-asserted-by":"crossref","first-page":"e210","DOI":"10.1515\/cclm-2022-0486","article-title":"Pseudoerythroblastosis on Sysmex XN hematology analyzers: a clue to Candida sepsis. Case report and literature review.","volume":"60","author":"La Gioia","year":"2022","journal-title":"Clin Chem Lab Med"},{"key":"key20260611074853_r5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/j.1751-553X.2011.01298.x","article-title":"Screening of sepsis using leukocyte cell population data from the Coulter automatic blood cell analyzer DxH800.","volume":"33","author":"Park","year":"2011","journal-title":"Int J Lab Hematol"},{"key":"key20260611074853_r6","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1136\/jclinpath-2017-204524","article-title":"Role of leucocytes cell population data in the early detection of sepsis.","volume":"71","author":"Urrechaga","year":"2018","journal-title":"J Clin Pathol"},{"key":"key20260611074853_r7","doi-asserted-by":"crossref","first-page":"454","DOI":"10.5937\/jomb0-41589","article-title":"Leukocyte cell population data as potential markers of Covid-19 disease characterization.","volume":"42","author":"Introcaso","year":"2023","journal-title":"J Med Biochem"},{"key":"key20260611074853_r8","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.cll.2024.04.001","article-title":"Advances in Hematology Analyzers Technology.","volume":"44","author":"Shean","year":"2024","journal-title":"Clin Lab Med"},{"key":"key20260611074853_r9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/ijlh.14387","article-title":"Definition of Significant Platelet Clumping: Should We Review All Samples With a Platelet Clumping Flag From Automated Hematology Analyzer?","volume":"47","author":"Woo","year":"2025","journal-title":"Int J Lab Hematol"},{"key":"key20260611074853_r10","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1515\/cclm-2021-1226","article-title":"The Flagging Features of the SysmexXn-10 Analyser for Detecting Platelet Clumps and the Impacts of Platelet Clumps on Complete Blood Count Parameters.","volume":"60","author":"Xu","year":"2022","journal-title":"Clin Chem Lab Med"},{"key":"key20260611074853_r11","doi-asserted-by":"crossref","DOI":"10.11613\/BM.2025.011002","article-title":"Red blood cell agglutination caused by ceftriaxone and its effect on erythrocyte parameters: a case report.","volume":"35","author":"Andrasic","year":"2025","journal-title":"Biochem Med (Zagreb)"},{"key":"key20260611074853_r12","doi-asserted-by":"crossref","first-page":"3859","DOI":"10.3390\/jcm9123859","article-title":"New Insights in Autoimmune Hemolytic Anemia: From Pathogenesis to Therapy.","volume":"9","author":"Barcellini","year":"2020","journal-title":"J Clin Med"}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/assets\/images\/upload\/xml_tif\/bm-36-2-021001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:26:02Z","timestamp":1782455162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/36\/2\/10.11613\/BM.2026.021001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,24]]},"published-print":{"date-parts":[[2026,6,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2026.021001","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}