Bacteriological and Serological Findings in a Further Case of Transfusion-Mediated Yersinia enterocolitica Sepsis

Abstract

A 13-year-old patient developed severe shock due to administration of a Yersinia enterocolitica-contaminated red blood cell concentrate. Y. enterocolitica (serotype O:9, biotype II) was cultivated from the residual blood in the blood bag and from a stool sample of the blood donor. In the donor's plasma immunoglobulin M (IgM), IgA, and IgG antibodies against Yersinia outer proteins (YopM, -H, -D, and -E) were found. Since the donor remembered a short-lasting, mild diarrhea 14 days prior to blood donation, a transient attack of Yersinia enteritis may be associated with a longer than expected period of asymptomatic bacteremia that causes contamination of donor blood. Serological screening for IgM antibodies against Yersinia outer proteins might offer a way to reduce the risk of transfusion-associated Y. enterocolitica sepsis.

Three years of haemovigilance in a general university hospital

“…Case 2 showed a possible contamination with a Gram-negative organism, Y. enterocolitica. Greatest attention in transfusion has been given to Y. enterocolitica, frequently associated with sepsis and death (Jones et al, 1993;McDonald et al, 1996;Strobel et al, 2000). Fortunately, the outcome was favourable in our patient.…”

Prevention of Yersinia enterocolitica, Pseudomonas fluorescens, and Pseudomonas putida outgrowth in deliberately inoculated blood by a novel pathogen‐reduction process

“…Y. enterocolitica is one of the predominant bacterial species frequently causing clinical sepsis. 1,2,5,6 From a variety of Y. enterocolitica serotypes, we selected the most common strains of microorganisms associated with blood contamination. Yersinia strains of serotypes O:3 and O:8 account for the majority cases of blood bacteremia 24 due to Yersinia contamination.…”

“…Incubation of RBCs at room temperature or washing of RBCs, as the elements of the INACTINE process, can contribute to some extent to the reduction in the number of bacteria in RBC units. 6,[28][29][30] To clarify the mechanism by which the INACTINE pathogen-reduction process achieved bacterial clearance in RBCs, sham control units were subjected to the full INACTINE process except for the addition of PEN110. Our experimental results showed that after 24hour incubation at room temperature and extensive washing, all sham-treated units were found to be culturenegative on Days 2 and 3 of storage.…”

“…5,6 The most common source of Y. enterocolitica in donated blood is donor gastroenteritis-related bacteremia. 2,6 P. fluorescens and P. putida are environmental microorganisms often isolated from the phlebotomy site. 7,8 Unlike other types of bacteria, psychrophilic species can proliferate during the storage of RBCs at 1 to 6ЊC from a very low (usually Յ1 CFU/mL) titers at the time of blood collection to clinically significant levels (>10 5 CFU/ mL).…”

“…Among the numerous human strains of Y. enterocolitica, serotype O:3 was chosen because it was the most frequently involved in transfusion-associated sepsis. 2,6,24 The other two strains of Y. enterocolitica represent isogenic pair of serotype O:8 (also a very common human pathogen and blood contaminant 25 ) with (P + ) and without (P -) virulence plasmid. 26 The plasmid-encoded genes enable the microorganism to be resistant to phagocytosis and complement-mediated killing.…”