Journal article
Septic transfusion case caused by a platelet pool with visible clotting due to contamination with Staphylococcus aureus
Transfusion (Philadelphia, Pa.), Vol.57(5), pp.1299-1303
05/2017
DOI: 10.1111/trf.14049
PMID: 28205241
Abstract
Contamination of platelet concentrates (PCs) with Staphylococcus aureus is one of the most significant ongoing transfusion safety risks in developed countries.
This report describes a transfusion reaction in an elderly patient diagnosed with acute myeloid leukemia, transfused with a 4-day-old buffy coat PC through a central venous catheter. The transfusion was interrupted when a large fibrous clot in the PC obstructed infusion pump flow. Shortly afterward, a red blood cell (RBC) unit transfusion started. After septic symptoms were developed, the RBC transfusion was also interrupted. While the RBC unit tested negative for bacterial contamination, the PC and the patient samples were found to be contaminated with a S. aureus strain that exhibited the same phenotypic and genome sequencing profiles. The isolated S. aureus forms biofilms and produces the superantigen enterotoxin-like U, which was detected in a sample of the transfused PCs. The patient received posttransfusion antibiotic treatment and had her original central line removed and replaced.
As the implicated PC had been tested for bacterial contamination during routine screening yielding negative results, this is a false-negative transfusion sepsis case. Using a point-of-care test could have prevented the transfusion reaction. This report highlights the increasing incidence of S. aureus as a major PC contaminant with grave clinical implications. Importantly, S. aureus is able to interact with platelet components resulting in visible changes in PCs.
Visual inspection of blood components before transfusion is an essential safety practice to interdict the transfusion of bacterially contaminated units.
Details
- Title: Subtitle
- Septic transfusion case caused by a platelet pool with visible clotting due to contamination with Staphylococcus aureus
- Creators
- Maria Loza-Correa - Canadian Blood ServicesYuntong Kou - Canadian Blood ServicesMariam Taha - Canadian Blood ServicesMiloslav Kalab - Agriculture and Agri-Food CanadaJennifer Ronholm - Health Canada, Ottawa, Ontario, CanadaPatrick M Schlievert - Department of Microbiology, Carver College of Medicine, Iowa City, IowaMichael P Cahill - Department of Microbiology, Carver College of Medicine, Iowa City, IowaRobert Skeate - Department of Microbiology, Carver College of Medicine, Iowa City, IowaChristine Cserti-Gazdewich - University Health Network, Toronto, Ontario, CanadaSandra Ramirez-Arcos - Canadian Blood Services
- Resource Type
- Journal article
- Publication Details
- Transfusion (Philadelphia, Pa.), Vol.57(5), pp.1299-1303
- DOI
- 10.1111/trf.14049
- PMID
- 28205241
- NLM abbreviation
- Transfusion
- ISSN
- 0041-1132
- eISSN
- 1537-2995
- Publisher
- United States
- Grant note
- DOI: 10.13039/501100000014, name: Canadian Blood Services
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Microbiology and Immunology; Internal Medicine
- Record Identifier
- 9984001212202771
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