Potential risk of blood transfusion-transmitted brucellosis in an endemic area of China

Brucellosis is a severe zoonotic disease that is increasingly prevalent in north China. A study evaluating Brucella infection in blood donors was conducted at Kashi central blood station, Xinjiang, China.

Four serologic and two molecular methods of detection of Brucella infection were used in plasma samples from blood donations collected from Kashi in northwest China, considered a brucellosis-endemic area. Blood donor samples collected in Shenzhen, southern China, a brucellosis-nonendemic area, were tested as a negative control group.

In 3896 plasma samples collected from Kashi central blood station, 135 (3.5%) plasma samples were reactive by the Rose Bengal plate test (RBPT), and 120 (3.1%) of the 135 RBPT-reactive sample were also reactive with the standard tube agglutination test (SAT), respectively. All samples of the control group of 399 blood samples from Shenzhen blood center tested negative with RBPT and SAT. Of 135 seroreactive plasma samples, 39 (1.0%) reacted with B. melitensis membrane protein extracts by enzyme-linked immunosorbent assay and 25 were reactive to either rBP26 or rOMP31 by Western blot. Thirteen plasma samples and two follow-up blood samples were identified as carrying Brucella DNA by quantitative polymerase chain reaction (PCR) and nested PCR. Overall 15 (1:300) Kashi blood donations were found positive by nucleic acid testing, confirmed specific by DNA sequencing.

The data indicate a probable high rate of Brucella bacteremia, suggesting a potential risk of transfusion-transmitted brucellosis. Blood donation screening for Brucella infection may be considered in the high Brucella-endemic areas of China.