The epidemiology of bacterial culture-positive and septic transfusion reactions at a large tertiary academic center: 2009 to 2016
- 1 August 2018
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 58 (8), 1933-1939
- https://doi.org/10.1111/trf.14789
Abstract
BACKGROUND: Bacterial contamination and associated septic transfusion reactions (STRs) remain the leading infectious risk to the blood supply. We sought to characterize the risk and clinical presentation of blood culture-positive transfusion reactions (BCPTRs) and STRs at our institution. STUDY DESIGN AND METHODS: A retrospective analysis was conducted of all suspected transfusion reactions reported to the transfusion service at a 1000-bed tertiary academic medical center from January 2009 to September 2016. Routine investigation included review of the clinical presentation, Gram stain, and bacterial culture of residual blood from the transfused product or associated blood bag. BCPTRs were defined by the presence of a positive bacterial culture in the blood product and/ or recipient. STRs met definitive Centers for Disease Control and Prevention hemovigilance criteria for transfusion-transmitted infection, with definite imputability and concordant bacterial culture of the blood product and recipient. RESULTS: A total of 688,514 blood products were transfused during the study period, 3170 transfusion reactions were reported, and 18 (0.57%) were BCPTRs of which seven (0.22%) were STRs. Fifteen of 18 (83.3%) BCPTRs and six of seven (85.7%) were associated with transfusion of apheresis platelets. Major symptoms and signs of BCPTRs included chills (67%), fever (61%), and nausea and vomiting (50%). Four of seven (57.1%) STRs were classified as severe or life-threatening. CONCLUSION: BCPTRs are rare yet potentially serious. The signs and symptoms of BCPTRs, and associated STRs, are not specific, posing risk of misclassification. Challenges surrounding reporting and case ascertainment underscore the need for laboratory measures to address residual risk of contamination.This publication has 20 references indexed in Scilit:
- Platelet transfusion therapy in sub‐Saharan Africa: bacterial contamination, recipient characteristics, and acute transfusion reactionsTransfusion, 2016
- Detection of septic transfusion reactions to platelet transfusions by active and passive surveillanceBlood, 2016
- Bacterial contamination of blood components: Norwegian strategies in identifying donors with higher risk of inducing septic transfusion reactions in recipientsTransfusion and Apheresis Science, 2014
- Addressing the risk of bacterial contamination of platelets within the United States: a history to help illuminate the futureTransfusion, 2012
- Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood ServiceTransfusion Medicine and Hemotherapy, 2011
- TRANSFUSION COMPLICATIONS: Bacterial culture reduces but does not eliminate the risk of septic transfusion reactions to single‐donor plateletsTransfusion, 2009
- Limiting and detecting bacterial contamination of apheresis platelets: inlet‐line diversion and increased culture volume improve component safetyTransfusion, 2009
- Screening platelet concentrates for bacterial contamination: low numbers of bacteria and slow growth in contaminated units mandate an alternative approach to product safetyVox Sanguinis, 2008
- Relationship between Bacterial Load, Species Virulence, and Transfusion Reaction with Transfusion of Bacterially Contaminated PlateletsClinical Infectious Diseases, 2008
- Bacterial Contamination of Blood ComponentsClinical Microbiology Reviews, 2005