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Published on: August 24, 2015
Bacterial contamination of platelet concentrates: incidence, significance, and prevention
1Department of Pathology and Medicine, McMaster University, and Canadian Blood Services, Hamilton, Ontario, Canada.
Abstract:
Severe transfusion reactions associated with bacteria and/or their products, during or following a blood transfusion, were one of the earliest recognized complications of allogeneic blood transfusions. Bacterial contamination of blood products has thus been a problem for many decades and at present is likely the most common microbiological cause of transfusion-associated morbidity and mortality. Transfusion-associated sepsis due to contaminated platelet concentrates appears to be much more common than that due to contaminated red blood cells. The overall incidence of contaminated cellular blood products is approximately 1 in 3,000. However, transfusion to a recipient of a contaminated platelet unit may not necessarily be associated with clinically apparent morbidity, because the majority of contaminated platelet units contain relatively few organisms. In a minority of instances, contaminated units contain large numbers of potentially virulent bacteria, as well as endotoxins, and their transfusion is often associated with significant recipient morbidity and mortality. The incidence of severe septic episodes has not been clearly established, but is probably of the order of 1 per 50,000 platelet units transfused. With heightened awareness in recent years of the possibility that platelet transfusion-associated septic episodes can occur, a variety of measures have been proposed, and in some cases implemented, to try to prevent and control this transfusion risk.
Insights
Bacterial contamination in blood transfusions, especially platelets, can cause severe sepsis. While overall contamination is 1 in 3,000, severe septic episodes are estimated at 1 in 50,000 platelet units, prompting new preventative measures.
Area of Science:
- Transfusion Medicine
- Microbiology
- Public Health
Background:
- Bacterial contamination is a long-standing complication of allogeneic blood transfusions.
- It remains the leading microbiological cause of transfusion-associated morbidity and mortality.
- Platelet concentrates are more frequently implicated in transfusion-associated sepsis than red blood cells.
Purpose of the Study:
- To review the incidence and impact of bacterial contamination in blood products.
- To highlight the risks associated with transfusion-transmitted sepsis, particularly from platelet concentrates.
- To discuss current and proposed strategies for preventing and mitigating this transfusion risk.
Main Methods:
- Review of historical data and current literature on bacterial contamination in blood products.
- Analysis of incidence rates for contaminated cellular blood products and transfusion-associated sepsis.
- Examination of factors influencing morbidity and mortality, including bacterial load and endotoxins.
Main Results:
- The incidence of contaminated cellular blood products is approximately 1 in 3,000.
- Severe septic episodes are estimated to occur in about 1 in 50,000 platelet units transfused.
- While many contaminated units have low organism counts, some contain virulent bacteria and endotoxins, leading to severe patient outcomes.
Conclusions:
- Bacterial contamination of blood products, particularly platelets, poses a significant risk of transfusion-associated sepsis.
- The incidence of severe septic episodes necessitates ongoing vigilance and the implementation of preventative measures.
- Heightened awareness has led to the development and application of strategies to control this transfusion-associated risk.
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