Methicillin-resistant Staphylococcus aureus sepsis associated with the transfusion of contaminated platelets: a case report
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Published on: August 24, 2015
S Sapatnekar1, E M Wood, J P Miller
1University Hospitals of Cleveland, OH 44106, USA.
Background:
Platelet transfusion-associated sepsis is usually due to donor skin flora introduced into the unit during phlebotomy. An unusual case of a platelet component contaminated with methicillin-resistant Staphylococcus aureus (MRSA) is reported.
Case Report:
A 54-year-old man, terminally ill with progressive non-Hodgkin's lymphoma, developed fever and hypotension during a platelet transfusion. He was receiving multiple antibiotics, including vancomycin. Blood cultures taken soon after transfusion were negative. An aliquot taken from the platelet pool grew MRSA at a count of 1.6 x 10(8) CFUs per mL. One of the individual bags constituting the pool showed MRSA at a count of 5.1 x 10(8) CFUs per mL. The patient died soon after the platelet transfusion. This case was reported to the FDA and submitted to the BaCon Study. The identity of the isolate and its methicillin resistance were confirmed by the CDC as part of the BaCon Study protocol. The source of contamination of the implicated unit could not be established with certainty.
Conclusion:
The emergence of antimicrobial-resistant organisms poses additional challenges for the diagnosis and treatment of transfusion-associated sepsis. Measures to prevent or intercept the transfusion of contaminated platelets should be developed.
Insights
A patient receiving a platelet transfusion developed sepsis from methicillin-resistant Staphylococcus aureus (MRSA). This case highlights the risks of antimicrobial-resistant organisms in transfusion-associated sepsis.
Area of Science:
- Infectious Diseases
- Hematology
- Public Health
Background:
- Platelet transfusion-associated sepsis typically results from bacterial contamination during collection.
- An unusual case involving methicillin-resistant Staphylococcus aureus (MRSA) contamination in a platelet component is presented.
Observation:
- A patient with non-Hodgkin's lymphoma developed fever and hypotension during a platelet transfusion.
- Blood cultures were negative, but the platelet pool and an individual bag showed high counts of MRSA.
- The patient's condition deteriorated, and he died shortly after the transfusion.
Findings:
- The implicated platelet unit was heavily contaminated with MRSA (5.1 x 10^8 CFUs/mL).
- Methicillin resistance was confirmed by the CDC.
- The exact source of contamination could not be determined.
Implications:
- Antimicrobial-resistant organisms present significant challenges in diagnosing and treating transfusion-associated sepsis.
- Development of strategies to prevent or intercept contaminated platelet transfusions is crucial.
- This case underscores the importance of vigilance in blood product safety and infection control.
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02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...