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Reducing the risk of bacterial contamination of cellular blood components
1Department of Pathology and Molecular Medicine, McMaster University Medical Centre, Hamilton, Ontario, Canada.
Abstract:
Transfusion-associated septic reactions occurring during or following the transfusion of cellular blood components was one of the earliest recognised complications of allogeneic blood transfusions. The presence of bacteria in cellular blood products thus has been a problem for many decades and currently it is the most common microbiological cause of transfusion-associated morbidity and mortality. Transfusion-associated septic reactions due to contaminated platelet concentrates appear to be much more common than those due to red cell concentrates. The prevalence of contaminated cellular blood products (red cells and platelets) is approximately 1 in 2,000. However, the transfusion to a recipient of a contaminated blood product may not be associated with morbidity, because many contaminated blood product units contain only few bacteria and such transfusions may be innocuous to the recipient. In other instances, contaminated blood product units may contain large numbers of virulent bacteria and endotoxins, and their transfusion may be associated with significant morbidity and may even be lethal to the recipient. The prevalence of severe episodes of transfusion-associated sepsis has not been clearly established, but is probably of the order of 1 in 50,000 for platelet units and 1 in 500,000 for red blood cell units transfused. As a result of the increased recognition that such transfusion-associated septic episodes can occur, a variety of measures have been proposed to try to prevent and/or control the rate of contamination of blood products.
Insights
Bacterial contamination in cellular blood products, especially platelets, is a significant cause of transfusion-associated sepsis, leading to morbidity and mortality. Prevention strategies are crucial to mitigate these risks.
Area of Science:
- Transfusion Medicine
- Microbiology
- Hematology
Background:
- Transfusion-associated septic reactions are a known complication of allogeneic blood transfusions.
- Bacterial contamination of cellular blood products is the leading microbiological cause of transfusion-related morbidity and mortality.
- Septic reactions are more frequent with platelet concentrates than red blood cell concentrates.
Purpose of the Study:
- To review the prevalence and impact of bacterial contamination in cellular blood products.
- To highlight the risks associated with transfusion-transmitted sepsis.
- To discuss the importance of prevention and control measures for blood product contamination.
Main Methods:
- Literature review on transfusion-associated sepsis.
- Analysis of prevalence data for contaminated blood products.
- Discussion of clinical outcomes associated with bacterial contamination.
Main Results:
- The prevalence of contaminated cellular blood products (red cells and platelets) is approximately 1 in 2,000.
- Severe transfusion-associated sepsis occurs in about 1 in 50,000 platelet units and 1 in 500,000 red blood cell units.
- The clinical outcome of transfusion with contaminated products varies based on bacterial load and virulence.
Conclusions:
- Bacterial contamination of blood products remains a critical safety concern in transfusion medicine.
- Effective prevention and control measures are essential to reduce transfusion-associated sepsis.
- Further research is needed to establish the exact prevalence of severe septic episodes.