Recipient sepsis caused by <i>Lactococcus garvieae</i> contamination of platelets from a donor with colon cancer

Nakamura, Shuichi; Nakai, K.; Sakata, Momoko; Nagaoka, Yoshio; Yoshida, Kozue; Katsumata, Uichiro; Chiba, Tetsuhiro; Matsubayashi, Keiji

doi:10.1111/vox.12740

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…In view of this and other reports that described sepsis associated with L. garvieae infection [ 11 , 13 , 50 , 51 ], the knowledge of virulence factors and resistance mechanisms associated with the Lactococcus genera and L. garvieae species is detrimental.…”

Section: Discussionmentioning

confidence: 91%

“…In 2018, the first case of transfusion-transmitted L. garvieae resulting from a platelet transfusion in an adult hospitalized individual was described [ 13 ]. Here, we describe a cluster of transmission, with three cases of sepsis in onco-hematologic pediatric patients, derived by transfusion-transmitted L. garvieae from platelet concentrates (PCs) of the same donor.…”

Section: Introductionmentioning

confidence: 99%

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Evidence of pediatric sepsis caused by a drug resistant Lactococcus garvieae contaminated platelet concentrate

Colagrossi

Costabile

Scutari

et al. 2022

Emerging Microbes & Infections

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Owing to an increasing number of infections in adults, Lactococcus (L.) garvieae has gained recognition as an emerging human pathogen, causing bacteraemia and septicaemia. In September 2020, four paediatric onco-hematologic patients received a platelet concentrate from the same adult donor at Bambino Gesù Children’s Hospital IRCCS, Rome. Three of four patients experienced L. garvieae sepsis one day after transfusion. The L. garvieae pediatric isolates and the donor’s platelet concentrates were retrospectively collected for whole-genome sequencing and shot-gun metagenomics, respectively (Illumina HiSeq). By de novo assembly of the L. garvieae genomes, we found that all three pediatric isolates shared a 99.9% identity and were characterized by 440 common SNPs. Plasmid pUC11C (conferring virulence properties) and the temperate prophage Plg-Tb25 were detected in all three strains. Core SNP genome-based maximum likelihood and Bayesian trees confirmed their phylogenetic common origin and revealed their relationship with L. garvieae strains affecting cows and humans (bootstrap values >100 and posterior probabilities = 1.00). Bacterial reads obtained by the donor’s platelet concentrate have been profiled with MetaPhlAn2 (v.2.7.5); among these, 29.9% belonged to Firmicutes, and 5.16% to Streptococcaceae (>97% identity with L. garvieae ), confirming the presence of L. garvieae in the platelet concentrate transfusion. These data showed three episodes of sepsis for the first time due to a transfusion-associated transmission of L. garvieae in three pediatric hospitalized hematology patients. This highlights the importance to implement the screening of platelet components with new human-defined pathogens for ensuring the safety of blood supply, and more broadly, for the surveillance of emerging pathogens.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Evidence of pediatric sepsis caused by a drug resistant Lactococcus garvieae contaminated platelet concentrate

Colagrossi

Costabile

Scutari

et al. 2022

Emerging Microbes & Infections

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“…In many cases, a septic transfusion reaction is identified when investigations following the transfusion reaction identify the same bacterial strain in the PC and the donorʼs blood . In some scenarios, bacteria may contaminate units from a donor with asymptomatic bacteremia . After release of the unit to the transfusion service, small pinhole leaks or other bag leaks may also cause contamination of the unit …”

Section: Discussionmentioning

confidence: 99%

A suspected septic transfusion reaction associated with posttransfusion contamination of a platelet pool by vancomycin‐resistant Enterococcus faecium

et al. 2019

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BACKGROUND: Vancomycin-resistant enterococci (VRE) are antibiotic-resistant organisms associated with both colonization and serious life-threatening infection in health care settings. Contamination of platelet concentrates (PCs) with Enterococcus can result in transfusion-transmitted infection.CASE PRESENTATION: This report describes the investigation of a septic transfusion case involving a 27-year-old male patient with relapsed acute leukemia who was transfused with a 5-day-old buffy coat PC pool and developed fever and rigors.DISCUSSION: Microbiology testing and pulse-field gel electrophoresis (PFGE) was done on patient blood cultures obtained from peripheral and central lines. Microbiology and molecular testing were also performed on the remaining posttransfusion PC pool, which was refrigerated for 24 hours before microbiology testing. Red blood cell (RBC) and plasma units associated with the implicated PCs were screened for microbial contamination. Patient blood cultures obtained from peripheral and central lines yielded vancomycin-resistant Enterococcus faecium. Gram stain of a sample from the platelet pool was negative but coagulase-negative Staphylococcus (CNST) and VRE were isolated on culture. Antibiotic sensitivity and PFGE profiles of several VRE isolates from the patient before and after transfusion, and the PC pool, revealed that all were closely related. Associated RBC and plasma components tested negative for microbial contamination. CONCLUSIONS: Microbiological and molecularinvestigations showed a relationship between VRE isolated from the patient before and after transfusion, and therefore it is postulated that a patient-to-PC retrograde contamination (from either blood or skin) occurred. As the CNST isolated from the PC pool was not isolated from patient samples, its implication in the transfusion event is unknown. V ancomycin-resistant enterococci (VRE), which comprise the species Enterococcus faecium and Enterococcus faecalis, are health care-associated antibiotic-resistant organisms implicated in both serious life-threatening infection and human colonization and environmental contamination. 1-3 Patients with VRE bacteremia are at greater risk for longer hospital stay and mortality than patients with bacteremia caused by vancomycin-susceptible enterococci. 4 Patients at highest risk for VRE bacteremia include those admitted to an ABBREVIATIONS: CNST = coagulase-negative Staphylococcus; ICU = intensive care unit; PCs = platelet concentrates; PFGE = pulse-field gel electrophoresis; RSV = respiratory syncytial virus; VRE = vancomycin-resistant enterococci. From the

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“…The first case of transfusion-transmitted Lactococcus garvieae sepsis caused by a contaminated PC from a donor who consumed raw octopus before blood donation was reported [41]. Retrospective examination of the laboratory results of the index donor revealed that his haemoglobin levels had been steadily decreasing, which led to the detection of a latent colon cancer.…”

Section: Detection Systemsmentioning

confidence: 99%

The international experience of bacterial screen testing of platelet components with automated microbial detection systems: An update

2022

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In 2014, the bacterial subgroup of the Transfusion‐Transmitted Infectious Diseases working party of ISBT published a review on the International Experience of Bacterial Screen Testing of Platelet Components (PCs) with an Automated Microbial Detection System. The purpose of this review, which is focused on publications on or after 2014, is to summarize recent experiences related to bacterial contamination of PCs and the use of an automated culture method to safeguard the blood supply. We first reviewed septic transfusion reactions after PC transfusion as reported in national haemovigilance systems along with a few reports from various countries on bacterial contamination of blood products. Next, we reviewed PC automated culture protocols employed by national blood services in the United Kingdom, Australia, Canada and large blood collection organization and hospital transfusion services in the United States. Then, we acknowledged the limitations of currently available culture methodologies in abating the risks of transfusion‐transmitted bacterial infection, through a review of case reports. This review was neither meant to be critical of the literature reviewed nor meant to identify or recommend a best practice. We concluded that significant risk reduction can be achieved by one or a combination of more than one strategy. No one approach is feasible for all institutions worldwide. In selecting strategies, institutions should consider the possible impact on platelet components availability and entertain a risk‐based decision‐making approach that accounts for operational, logistical and financial factors.

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Recipient sepsis caused by Lactococcus garvieae contamination of platelets from a donor with colon cancer

Cited by 7 publications

References 5 publications

Evidence of pediatric sepsis caused by a drug resistant Lactococcus garvieae contaminated platelet concentrate

Evidence of pediatric sepsis caused by a drug resistant Lactococcus garvieae contaminated platelet concentrate

A suspected septic transfusion reaction associated with posttransfusion contamination of a platelet pool by vancomycin‐resistant Enterococcus faecium

The international experience of bacterial screen testing of platelet components with automated microbial detection systems: An update

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