Impact on Patient Outcome Following Transfusion of Bacterially Contaminated Platelets

Abstract

This study examined the clinical outcome of every patient who received a bacterially contaminated unit of platelets at The University of Texas M.D. Anderson Cancer Center, Houston, during 2007. Samples of platelets were aerobically cultured and read for 1 day at 35 degrees C. Positive bottles were subcultured in the appropriate media. The effect of independent variables in the clinical outcome of patients infused with bacterially contaminated platelet units was analyzed. A total of 23,199 platelet units were transfused, 71 of which were bacterially contaminated units; 8 were apheresis platelets and 63 were whole blood platelets. Of the 71 units, 70 were contaminated with gram-positive bacteria and 1 with gram-negative bacteria. Only 1 patient developed fever, and coagulase-negative staphylococci were isolated from the transfused unit. Transfusion of fresh units and antibiotic therapy possibly explain the lack of clinical consequences in our patients.

Platelet transfusion is not associated with increased mortality or morbidity in patients undergoing cardiac surgery

“…Patients receiving platelets were older, had higher body mass index, lower rates of diabetes and dyslipidemia, higher rates of infective endocarditis, recent myocardial infarction and unstable angina, and exposure to aspirin or clopidogrel. On univariable analysis, platelet transfusion was associated with increased 30-day mortality (2.4% vs. 10.55%, p < 0.001), return to theatre for bleeding (3.23% vs. 13.37%, p < 0.001), and rates of any infection (9.26% vs. 19.17%, p < 0.001). After adjusting for confounders, platelet transfusion was not associated with increased risk of 30-day mortality or infective complications.…”

“…A total of 5233 patients met inclusion criteria, and 531 (10.15%) received intraoperative platelet transfusion (median two platelet doses, interquartile range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Patients receiving platelets were older, had higher body mass index, lower rates of diabetes and dyslipidemia, higher rates of infective endocarditis, recent myocardial infarction and unstable angina, and exposure to aspirin or clopidogrel.…”

“…11 Furthermore, there are conflicting reports on the effects of platelet transfusion and patient outcomes, with some studies suggesting an association with mortality and morbidity and others reporting no such associations. [12][13][14] We aimed to determine the possible association between intraoperative platelet transfusion with outcomes including mortality, infection, and thrombosis.…”

Bacteriological Safety of Blood Collected for Transfusion at University of Gondar Hospital Blood Bank, Northwest Ethiopia

“…This has been approved by study conducted in USA [33]. Moreover high resistance patterns observed for single and multiple antimicrobials are also a great concern that needs urgent attention.…”

Improving the performance of culture‐based bacterial screening by increasing the sample volume from 4 mL to 8 mL in aerobic culture bottles

“…Recent estimates of true contamination reported by PASSPORT surveillance and other national surveillance studies reflect a higher prevalence, somewhere in the range of 845 to 932 per million 6,8 . Interestingly, despite the relatively low sensitivity of culture‐based bacterial detection testing, STRs remain a relatively infrequent complication and an even less frequent cause of transfusion‐related mortality 5,14 . While it is generally believed that passive surveillance contributes to an underrecognition of STRs, a more likely explanation for the marked discrepancy between the incidence of true contamination and STRs is that not all bacterially contaminated products carry the same clinical significance.…”