Transfusion‐transmitted bacterial infection: risks, sources and interventions

Wagner, Stephen J.

doi:10.1111/j.0042-9007.2004.00410.x

Cited by 127 publications

(55 citation statements)

References 51 publications

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“…This emergence of this pattern from SHOT reporting led to the recommendation that strategies be developed to reduce this. Similar observations were made in France and elsewhere (Wagner, 2004). The Blood Services introduced diversion of the first 20 ml of each donation in 2002, and also methods to improve skin cleansing, which have to be meticulously performed.…”

Section: Reduction Of Unpredictable Transfusion Reactionssupporting

confidence: 89%

Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety

2013

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SummaryThe Serious Hazards of Transfusion (SHOT) UK confidential haemovigilance reporting scheme began in 1996. Over the 16 years of reporting, the evidence gathered has prompted changes in transfusion practice from the selection and management of donors to changes in hospital practice, particularly better education and training. However, half or more reports relate to errors in the transfusion process despite the introduction of several measures to improve practice. Transfusion in the UK is very safe: 2·9 million components were issued in 2012, and very few deaths are related to transfusion. The risk of death from transfusion as estimated from SHOT data in 2012 is 1 in 322 580 components issued and for major morbidity, 1 in 21 413 components issued; the risk of transfusion-transmitted infection is much lower. Acute transfusion reactions and transfusion-associated circulatory overload carry the highest risk for morbidity and death. The high rate of participation in SHOT by National Health Service organizations, 99·5%, is encouraging. Despite the very useful information gained about transfusion reactions, the main risks remain human factors. The recommendations on reduction of errors through a ‘back to basics’ approach from the first annual SHOT report remain absolutely relevant today.

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Section: Reduction Of Unpredictable Transfusion Reactionssupporting

confidence: 89%

Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety

2013

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“…As a result, the most predominant bacteria isolated are usually commensals of the skin or gastrointestinal tract flora. A report from the American Red Cross on detection of bacterial contamina- tion in platelets showed that the majority of isolates were Gram-positive aerobic pathogens (nearly 75%), in line with the organisms identified in platelet units implicated in cases of transfusion-associated sepsis (56% Gram-positive aerobes) [7].…”

Section: Bacterial Infectionsmentioning

confidence: 61%

“…The risk of bacterial infection has emerged as the major cause of transfusion related morbidity and mortality, in part due to the reduction of other risks [4,[7][8][9][10]. Bacterial contamination is more frequent in platelet concentrates (PLT) than in red blood components most likely because many microorganisms can survive and propagate under the storage conditions typically used for PLT (20-24°C), but less so for RBC (1-6°C) [8][9][10][11] As a consequence of the increasing awareness and clinical relevance of bacterial contamination of blood components, the AABB (formerly The American Association of Blood Banks) released standards to diminish bacterial TTI [12] in 2004.…”

Section: Bacterial Infectionsmentioning

confidence: 99%

Transfusion-transmitted infections

et al. 2007

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Although the risk of transfusion-transmitted infections today is lower than ever, the supply of safe blood products remains subject to contamination with known and yet to be identified human pathogens. Only continuous improvement and implementation of donor selection, sensitive screening tests and effective inactivation procedures can ensure the elimination, or at least reduction, of the risk of acquiring transfusion transmitted infections. In addition, ongoing education and up-to-date information regarding infectious agents that are potentially transmitted via blood components is necessary to promote the reporting of adverse events, an important component of transfusion transmitted disease surveillance. Thus, the collaboration of all parties involved in transfusion medicine, including national haemovigilance systems, is crucial for protecting a secure blood product supply from known and emerging blood-borne pathogens.

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“…In contrast, despite bacterial screening testing, the American Red Cross (ARC) published TTBI frequencies between 1:40,000 and 1:193,000 depending on the collecting procedure. The fatality rate was one in 500,000 platelet units [10]. Swissmedic described an estimated TTBI risk of 1:600,000 donations for the last decade [2]; after the introduction of pathogen inactivation procedure for all PC (2011), no further TTBI was confirmed [11].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Risk Minimisation Measures for Blood Components - Based on Reporting Rates of Transfusion-Transmitted Reactions (1997-2013)

Funk

Heiden

Volkers

et al. 2015

Transfus Med Hemother

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Background: To assess the impact of safety measures, we compared reporting rates of transfusion-related reactions before and after the implementation of six measures in 1999, 2004, 2006, 2008 and 2009. Methods: Reporting rates of transfusion-transmitted bacterial infection (TTBI), viral infection (TTVI) and immune-mediated transfusion-related acute lung injury (TRALI) were calculated on the basis of confirmed annual reports and distributed blood components. Results: The introduction of HCV NAT testing caused a significant reduction of HCV reporting rate from 1:0.6 to 1:83.16 million administered blood components (p < 0.0001), donor screening for antibodies to hepatitis B core antigen caused a reduction of HBV reporting rate from 1:2.90 to 1:10.70 million units (p = 0.0168). A significant reduction from 1:0.094 to 1:2.42 million fresh frozen plasma (FFP) units could also be achieved by risk minimisation TRALI measures (p < 0.0001). Implementation of pre-donation sampling did not result in a significant decrease in TTBI, whereas limitation of shelf life for platelet concentrate (PC) minimised the TTBI reporting rate from 1:0.088 to 1:0.19 million PC units (p = 0.041). For HIV NAT pool testing, no significant reduction in HIV transmission was found due to very low reporting rates (1:10 million versus 1:27 million blood components, p = 0.422). Conclusion: On the basis of haemovigilance data, a significant benefit could be demonstrated for four of six implemented safety measures.

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Transfusion‐transmitted bacterial infection: risks, sources and interventions

Cited by 127 publications

References 51 publications

Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety

Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety

Transfusion-transmitted infections

Evaluation of Risk Minimisation Measures for Blood Components - Based on Reporting Rates of Transfusion-Transmitted Reactions (1997-2013)

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