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Staphylococcus epidermidis bacteremia from transfusion of contaminated platelets: application of bacterial DNA
1Medical Service, Veterans Affairs Medical Center, Pittsburgh, Pennsylvania.
Abstract:
Septicemia is a rare complication of platelet transfusion. A case is reported of transfusion-associated septicemia in a 66-year-old man who received a 10-unit pool of platelets. During transfusion, he experienced rigors, wheezing, dyspnea, and fever. A total of four blood cultures drawn 10 and 36 hours after discontinuation of the transfusion grew Staphylococcus epidermidis. Culture of the residual platelet pool yielded S. epidermidis with a colony count of 10(5) organisms per mL. Strain identity of all four blood isolates and the platelet pool isolate was confirmed by gel electrophoresis of EcoRI and HindIII restriction digests of whole-cell DNA. There have been 31 prior reported cases of platelet transfusion-associated septicemia, of which 9 have been caused by coagulase-negative staphylococci. Systemic reactions to platelet transfusions should prompt consideration of transfusion-associated bacteremia as the cause.
Insights
Platelet transfusions can rarely cause septicemia (blood infection). A case report highlights Staphylococcus epidermidis infection transmitted via platelets, emphasizing the need to consider bacteremia in transfusion reactions.
Area of Science:
- Hematology
- Infectious Diseases
- Transfusion Medicine
Background:
- Septicemia is a serious, though uncommon, complication associated with platelet transfusions.
- Coagulase-negative staphylococci are a known cause of such transfusion-associated infections.
Observation:
- A 66-year-old male developed rigors, wheezing, dyspnea, and fever during a platelet transfusion.
- Blood cultures drawn post-transfusion and the residual platelet pool were positive for Staphylococcus epidermidis.
Findings:
- The platelet pool contained a high concentration of Staphylococcus epidermidis (10^5 organisms/mL).
- Molecular analysis confirmed the infecting strain was identical to the one in the platelet pool.
Implications:
- This case underscores the risk of transfusion-transmitted bacterial infections, particularly from platelet products.
- Clinicians should consider bacterial contamination as a cause for systemic reactions during or after platelet transfusions.