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Bacterial sepsis secondary to platelet transfusion: an adverse effect of extended storage at room temperature
Abstract:
In a 3-month period four episodes of bacterial sepsis related to contaminated random donor platelet concentrates were observed. Evaluation incriminated extended (5 or more days) platelet storage. To determine if platelets stored for longer periods were likely to have greater bacterial contamination, platelet concentrates were inoculated with bacteria and daily quantitative bacteriology was performed. In vitro studies using polyolefin bags indicated contamination could occur with a single organism of Staphylococcus epidermidis. By 72 hours, platelet concentrates contained from 10(3) to 10(8) organisms per 0.1 ml depending on the inoculum size. By 6 days all inoculated units contained 10(7) to 10(9) organisms per 0.1 ml.
Insights
Extended storage of platelet concentrates increases bacterial contamination risk. Longer platelet storage periods, especially beyond 5 days, are linked to higher bacterial loads, posing a sepsis risk.
Area of Science:
- Transfusion Medicine
- Microbiology
- Infectious Disease
Background:
- Bacterial sepsis associated with platelet transfusion poses a significant patient safety risk.
- Previous observations linked sepsis episodes to extended platelet storage durations.
Purpose of the Study:
- To investigate the correlation between extended platelet storage periods and the likelihood of bacterial contamination.
- To quantify bacterial growth in platelet concentrates over time.
Main Methods:
- Platelet concentrates were experimentally inoculated with bacteria (Staphylococcus epidermidis).
- Quantitative bacteriology was performed daily to assess bacterial proliferation.
- In vitro studies utilized polyolefin bags to evaluate contamination potential.
Main Results:
- Bacterial contamination was observed to occur even with a single organism (Staphylococcus epidermidis).
- Within 72 hours, platelet concentrates showed bacterial counts ranging from 10^3 to 10^8 organisms/0.1 ml.
- By 6 days of storage, all inoculated units reached bacterial concentrations of 10^7 to 10^9 organisms/0.1 ml.
Conclusions:
- Extended platelet storage, particularly beyond 5 days, significantly enhances bacterial proliferation.
- The risk of bacterial contamination and subsequent sepsis from platelet transfusions increases with storage duration.
- Current storage practices may require re-evaluation to mitigate transfusion-transmitted bacterial infections.