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Published on: August 24, 2015
Posttransfusion Sepsis Attributable to Bacterial Contamination in Platelet Collection Set Manufacturing Facility,
Abstract:
During May 2018‒December 2022, we reviewed transfusion-transmitted sepsis cases in the United States attributable to polymicrobial contaminated apheresis platelet components, including Acinetobacter calcoaceticus‒baumannii complex or Staphylococcus saprophyticus isolated from patients and components. Transfused platelet components underwent bacterial risk control strategies (primary culture, pathogen reduction or primary culture, and secondary rapid test) before transfusion. Environmental samples were collected from a platelet collection set manufacturing facility. Seven sepsis cases from 6 platelet donations from 6 different donors were identified in patients from 6 states; 3 patients died. Cultures identified Acinetobacter calcoaceticus‒baumannii complex in 6 patients and 6 transfused platelets, S. saprophyticus in 4 patients and 4 transfused platelets. Whole-genome sequencing showed environmental isolates from the manufacturer were closely related genetically to patient and platelet isolates, indicating the manufacturer was the most probable source of recurrent polymicrobial contamination. Clinicians should maintain awareness of possible transfusion-transmitted sepsis even when using bacterial risk control strategies.
Insights
Polymicrobial contamination in apheresis platelets caused sepsis cases, even with bacterial risk control strategies. Whole-genome sequencing identified a manufacturing facility as the likely source of recurrent contamination.
Area of Science:
- Infectious Diseases
- Microbiology
- Hematology
Background:
- Transfusion-transmitted sepsis is a rare but serious risk associated with blood product transfusions.
- Apheresis platelet components are essential for managing thrombocytopenia but can be susceptible to bacterial contamination.
Approach:
- Reviewed transfusion-transmitted sepsis cases linked to polymicrobial-contaminated apheresis platelets (May 2018–December 2022).
- Investigated bacterial isolates (Acinetobacter calcoaceticus–baumannii complex, Staphylococcus saprophyticus) from patients and components.
- Conducted whole-genome sequencing on clinical, component, and environmental isolates from a platelet collection set manufacturer.
Key Points:
- Seven sepsis cases across six states were identified, resulting in three deaths.
- Bacterial isolates from patients and platelets matched those found in environmental samples from a manufacturing facility.
- Whole-genome sequencing strongly implicated the manufacturing facility as the source of recurrent polymicrobial contamination.
Conclusions:
- Even with implemented bacterial risk control strategies, transfusion-transmitted sepsis remains a concern.
- Manufacturing processes for platelet collection sets can be a source of microbial contamination.
- Enhanced vigilance and improved manufacturing controls are crucial to mitigate transfusion-related sepsis risks.
