To underscore the risks of fatal bacterial infection following platelet transfusions, the Centers for Disease Control and Prevention recently published these two case reports.
Case reports: Two fatal infections after transfusion
Case reports: Two fatal infections after transfusion
Contaminated platelets kill patient in < 24 hours
To underscore the risks of fatal bacterial infection following platelet transfusions, the Centers for Disease Control and Prevention recently published these two case reports.1
- Patient A. In October 2004, a 74-year-old man in Ohio with leukemia received a transfusion consisting of a pool of five platelet unit concentrates. Before transfusion, the pooled platelet unit had been tested for bacterial contamina-tion with a reagent strip test (Multistix, Bayer Diagnostics, Tarrytown, NY) to determine the pH level, a means for detecting the presence of bacteria. Because the pH test result was within the accepted range for quality control (i.e., pH > 6.4) of the clinic’s blood bank, the pooled unit was approved for transfusion. After transfusion, the patient had hypotension the same day and was admitted to a local hospital. The patient’s blood cultures grew Staphylococcus aureus, and the patient died 21 days after hospital admission. S. aureus also was cultured from the leftover platelet unit bag; isolates from the patient’s blood and the platelet bag were indistinguishable by pulsed-field gel electrophoresis (PFGE).
- Patient B. In December 2004, a 79-year-old man in Utah received a transfusion of pheresis platelets for thrombocytopenia after coronary artery bypass surgery. Before transfusion, platelets from the unit bag were tested for bacterial contamination with liquid culture media (BacT/Alert, BioMerieux Inc., Durham, NC) by using 4 mL in a standard aerobic blood culture bottle and were found to be negative after five days’ incubation. Approximately one hour after transfusion, the patient had shortness of breath, chills, and a temperature of 102.9º F (39.4º C) and became hypotensive. Subsequently, the patient had multiple thrombotic events and died 27 hours later. S. lugdunensis was cultured from the patient’s blood and the leftover platelet bag; these isolates were indistinguishable by PFGE.
1. Centers for Disease control and Prevention. Fatal bacterial infections associated with platelet transfusion — United States, 2004. MMWR 2005; 54(07):168-170.