Bacterial Contamination of Platelet Units: A Case Report and Literature Survey With Review of Upcoming American Association of Blood Banks Requirements

Archives of Pathology & Laboratory Medicine, Mar 2004 by Burns, Kathleen H, Werch, Jochewed B

Clinical sequelae of contaminated platelet transfusion can be severe to fatal and compel us to pay attention to this iatrogenic cause of morbidity and mortality. It is critical that physicians are aware of this problem and seriously consider the possibility of bacterial contamination when investigating febrile transfusion reactions, particularly in cases of platelet transfusion. Improvements in the detection of bacterial contamination are challenged to provide not only sensitivity and specificity, but also logistic and economic efficiency to provide a safer platelet supply to patients, who are unique in their needs and vulnerabilities.

Previous studies to detect bacterial contamination in platelets have been supported by a Moran Foundation Award from Baylor College of Medicine Department of Pathology to Dr Werch. Dr Burns is a Medical Scientist Training Program student supported by NIH grant T32GM07330.

References

1. Engstrand M, Engstrand L, Hogman CF, Hambraeus A, Branth S. Retrograde transmission of Proteus mirabilis during platelet transfusion and the use of arbitrarily primed polymerasc chain reaction for bacteria typing in suspected cases of transfusion transmission of infection. Transfusion. 1995:35:871-873.

2. American Association of Blood Banks (AABB). Further Guidance on Methods to Detect Bacterial Contamination of Platelet Components. Bethesda, Md: AABB; October 1, 2003. Association Bulletin #03-12.

3. Wagner SJ, Robinette D, Friedman Ll, Miripol J. Diversion of initial blood flow to prevent whole-blood contamination by skin surface bacteria: an in vitro model. Transfusion. 2000;40:335-338.

4. Wollowitz S. Fundamentals of the psoralen-based Helinx technology for inactivation of infectious pathogens and leukocytes in platelets and plasma. Sem Hematol. 2001;38(suppl 11):4-11.

5. Werch JB, Mhawech P, Stager CE, Banez El, Lichtiger B. Detecting bacteria in platelet concentrates by use of reagent strips. Transfusion. 2002:42:1027-1031.

6. Brecher ME, Means N, Jere CS, Heath D, Rothenberg S, Stutzman LC. Evaluation of an automated culture system for detecting bacterial contamination of platelets: an analysis with 15 contaminating organisms. Transfusion. 2001 ;41: 477-482.

7. Brecher ME, Hay SN, Rothenberg S). Monitoring of apheresis platelet bacterial contamination with an automated liquid culture system: a university experience. Transfusion. 2003:43:974-978.

8. AuBuchon JP, Cooper LK, Leach MF, Zuaro DE, Schwartzman JD. Experience with universal bacterial culturing to detect contamination of apheresis platelet units in a hospital transfusion service. Transfusion. 2002:42:855-861.

9. McDonald CP, Hartley S, Orchard K, et al. Fatal Clostridium perfringcns sepsis from a pooled platelet transfusion. Transtus Med. 1998:8:19-22.

10. Buchholz DH, Young VM, Friedman NR, Reilly IA, Mardiney MR Jr. Bacterial proliferation in platelet products stored at room temperature. Transfusioninduced Enterobacter sepsis. N Engl J Med. 1971:285:429-433.

11. Arnow PM, Weiss LM, Weil D, Rosen NR. Escherichia coli sepsis from contaminated platelet transfusion. Arch Intern Med. 1986:146:321-324.